MEDICARE: CRYSTALL R YOUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency		OH

General Provider Information

NPI Number	:	1689532418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTALL R YOUNG

Provider Business Mailing Address
First Line	:	3803 DINA TER APT 8
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6525
Country	:	US
Telephone Number	:	513-413-9370
Fax Number	:	513-413-9370

Provider Business Practice Location Address
First Line	:	3803 DINA TER APT 8
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6525
Country	:	US
Telephone Number	:	513-413-9370
Fax Number	:	513-413-9370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ CRYSTALL R YOUNG ” Practice Location

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