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General NPI Number Information
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NPI Number | 1508753427
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Entity Type | Organization
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Legal Business Name | CROWNED CRYSTAL CORPORATION
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 2622 LAVENDER LN
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City | GLENN HEIGHTS
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State | TX
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Zip | 75154-2156
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Country | US
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Telephone | 225-678-8624
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Fax |
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Provider Business Mailing Address
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Address Line | 2622 LAVENDER LN
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City | GLENN HEIGHTS
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State | TX
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Zip | 75154-2156
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Country | US
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Telephone | 214-601-8648
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | CRYSTAL JUDSON STEWART
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Credential | RN, BSM, HHP
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Telephone | 214-601-8648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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