Crystal Nursing Rehabilitation, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CRYSTAL NURSING REHABILITATION, LLC

Practice address

3245 Vera Cruz Ave N
Crystal, MN 55422-2708

Phone

(763) 971-6300

Fax

(763) 971-6328

NPI assigned

Jan 21, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ephram Mordy Lahasky

Title

President/Manager

Phone

(646) 772-3668

Specialties & licenses 1

Addresses

Other names 1

• Centennial Gardens for Nursing and Rehabilitation Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1013374008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 VERA CRUZ AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554222708",
            "telephone_number": "763-971-6300",
            "fax_number": "763-971-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 VERA CRUZ AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554222708",
            "telephone_number": "763-971-6300",
            "fax_number": "763-971-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL NURSING REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "LAHASKY",
        "authorized_official_first_name": "EPHRAM",
        "authorized_official_middle_name": "MORDY",
        "authorized_official_title_or_position": "PRESIDENT/MANAGER",
        "authorized_official_telephone_number": "646-772-3668",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Gardens for Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittni Grace Crane, PHARM. D
• Crystal Dental Care Inc
• Crystal New Hope Medical Clinic
• Crystal New Hope Medical Clinic
• Crystal New Hope Medical Clinic Inc
• Crystal Vision Clinic PA
• Crystalhomes LLC
• Christian M Daleiden, M.D.
• Sadiq Datoo, RPH
• Katilyn Marie Davis, CNP

• Skilled Nursing Facility in Crystal, MN
• Providers in Crystal, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.