Provider Demographics
NPI:1811340821
Name:CRYSTAL CLEAR SOLUTIONS L.L.C.
Entity type:Organization
Organization Name:CRYSTAL CLEAR SOLUTIONS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-588-0141
Mailing Address - Street 1:110 E CENTER ST # 2999
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-2908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 E CENTER ST # 2999
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-2908
Practice Address - Country:US
Practice Address - Phone:605-588-0141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD253Z00000X251G00000X
SD251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based