Provider Demographics
NPI:1811390008
Name:CRYSTAL RUN DAYCARE CENTER INC
Entity Type:Organization
Organization Name:CRYSTAL RUN DAYCARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIDIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LESHCHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-730-3008
Mailing Address - Street 1:2115 SURF AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2108
Mailing Address - Country:US
Mailing Address - Phone:718-730-3008
Mailing Address - Fax:718-975-4337
Practice Address - Street 1:2912 BRIGHTON 12TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4754
Practice Address - Country:US
Practice Address - Phone:718-975-4334
Practice Address - Fax:718-975-4337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home