Crystal Social Service Inc

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

CRYSTAL SOCIAL SERVICE INC

Practice address

15819 Schoolcraft St
Detroit, MI 48227-1749

Phone

(313) 493-4900

Fax

(313) 493-4904

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert McPherson

Title

Ceo

Phone

(313) 493-4900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255448262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15819 SCHOOLCRAFT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271749",
            "telephone_number": "313-493-4900",
            "fax_number": "313-493-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15819 SCHOOLCRAFT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271749",
            "telephone_number": "313-493-4900",
            "fax_number": "313-493-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL SOCIAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCPHERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-493-4900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4377557",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Public Health or Welfare Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Public Health or Welfare Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.