Provider Demographics
NPI:1821305491
Name:KRYSTSTELLA HEALTH, INC.
Entity Type:Organization
Organization Name:KRYSTSTELLA HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:AHOUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:240-482-7446
Mailing Address - Street 1:630 FREEDOM BUSINESS CTR DR
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1331
Mailing Address - Country:US
Mailing Address - Phone:610-768-7700
Mailing Address - Fax:
Practice Address - Street 1:630 FREEDOM BUSINESS CTR DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1331
Practice Address - Country:US
Practice Address - Phone:610-768-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health