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General NPI Number Information
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NPI Number | 1689063018
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Entity Type | Organization
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Legal Business Name | CRYSTAL HOME HEALTH CARE
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 245 W BRUCETON RD
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City | PITTSBURGH
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State | PA
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Zip | 15236-4237
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Country | US
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Telephone | 412-641-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 245 W BRUCETON RD
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City | PITTSBURGH
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State | PA
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Zip | 15236-4237
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Country | US
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Telephone | 412-641-9898
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ELON MWAURA
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Credential | PA-C
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Telephone | 412-641-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4322279
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License Number State | PA
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