Crystal Cove Home Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL2704H Issued in AZ

Legal business name

CRYSTAL COVE HOME CARE LLC

Practice address

4492 E Laurel Ave
Gilbert, AZ 85234-7651

Phone

(480) 633-7122

Fax

(480) 248-6114

NPI assigned

Feb 13, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Erlinda Villa Canoy, B. S. FINANCE

Title

Manager

Phone

(480) 633-7122

Specialties & licenses 1

Addresses

Other names 1

• Crystal cove home care Lic. Doing business as

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1336530278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4492 E LAUREL AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852347651",
            "telephone_number": "480-633-7122",
            "fax_number": "480-248-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4492 E LAUREL AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852347651",
            "telephone_number": "480-633-7122",
            "fax_number": "480-248-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL COVE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "CANOY",
        "authorized_official_first_name": "ERLINDA",
        "authorized_official_middle_name": "VILLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-633-7122",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B. S. FINANCE"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL2704H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal cove home care Lic.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessika Crump
• Rianne Cruthis, FNP-BC
• Caitlin Cruz
• Staci Ann Cruz, PA C
• Stefanie Cruz
• Elisa Monique Csader, PMHNP-BC
• Marilyn Cue
• Lynda Cuevas
• Mya Cuevas
• Yinping Cui

• Assisted Living Facility in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.