Crystal Oaks Nursing and Rehab LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CRYSTAL OAKS NURSING AND REHAB LLC

Practice address

1500 Calvary Church Road
Festus, MO 63028-4125

Phone

(636) 933-1818

NPI assigned

Dec 20, 2023

Last updated

Dec 20, 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

Mr. Shafiq Malik

Title

President

Phone

(573) 335-3044

Specialties & licenses 1

Addresses

Tax ID family

Crystal Oaks2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Crystal Oaks Nursing and Rehab LLC

  dba Crystal Oaks

  • Skilled Nursing Facility
  • Festus, MO
  • NPI 1841909694
  NPD tax ID

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1316716277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 BROADWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014403",
            "telephone_number": "573-335-3044",
            "fax_number": "573-335-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CALVARY CHURCH ROAD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284125",
            "telephone_number": "636-933-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL OAKS NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "SHAFIQ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-335-3044",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamra Lynn Crouch, FNP
• Crystal Cities Surgery Center (Twin Cities Surgery Center)
• Crystal City Foot & Ankle Care PC
• Crystal City Pulmonary Critical Care & Sleep Medicine
• Crystal Oaks Long Term Care (Crystal Oaks)
• Crystal Oaks Nursing and Rehab LLC (Crystal Oaks)
• Andrea L Cuneio
• Rebecca Jean Dalton, MSN, PMHNP-BC
• Daniel E. Cox, M.D., LLC
• James R Dapron

• Assisted Living Facility in Festus, MO
• Providers in Festus, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.