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General NPI Number Information
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NPI Number | 1902329147
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Entity Type | Organization
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Legal Business Name | CRYSTAL HOSPICE CARE LLC
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/12/2025
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Provider Practice Location Address
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Address Line | 801 E CAMPBELL RD STE 142
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City | RICHARDSON
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State | TX
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Zip | 75081-1856
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Country | US
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Telephone | 469-327-5590
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Fax | 469-327-5557
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Provider Business Mailing Address
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Address Line | 801 E CAMPBELL RD STE 142
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City | RICHARDSON
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State | TX
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Zip | 75081-1856
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Country | US
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Telephone | 469-327-5590
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Fax | 469-327-5557
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY NOONAN
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Credential |
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Telephone | 469-327-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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