Crystal CMM Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

CRYSTAL CMM HOME CARE LLC

Practice address

60 N Dearborn St
Philadelphia, PA 19139-2738

Phone

(267) 971-2580

NPI assigned

May 31, 2023

Last updated

May 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crystal Green

Title

President

Phone

(267) 971-2580

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1093408551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N DEARBORN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191392738",
            "telephone_number": "267-971-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N DEARBORN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191392738",
            "telephone_number": "267-971-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CMM HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-971-2580"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• In Home Supportive Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.