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General NPI Number Information
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NPI Number | 1437147907
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Entity Type | Organization
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Legal Business Name | CREST SERVICES
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3015 MERLE HAY RD SUITE 6
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City | DES MOINES
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State | IA
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Zip | 50310-1270
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Country | US
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Telephone | 515-331-1200
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Fax | 515-331-1220
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Provider Business Mailing Address
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Address Line | 3015 MERLE HAY RD SUITE 6
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City | DES MOINES
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State | IA
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Zip | 50310-1270
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Country | US
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Telephone | 515-331-1200
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Fax | 515-331-1220
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL
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Name | KRISTI LEE SONSTEBY
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Credential | R.N.
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Telephone | 952-941-3175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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