Crystalhomes LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CRYSTALHOMES LLC

Practice address

4825 Douglas Dr N
Crystal, MN 55429-3535

Phone

(651) 755-5026

NPI assigned

Apr 3, 2026

Organization subpart

No

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

Authorized official

Name

Olajumoke O Disu

Title

Owner

Phone

(651) 755-5026

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1775174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775174400000",
    "number": "1871434845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 DOUGLAS DR N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293535",
            "telephone_number": "651-755-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 DOUGLAS DR N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554293535",
            "telephone_number": "651-755-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTALHOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A",
        "authorized_official_last_name": "DISU",
        "authorized_official_first_name": "OLAJUMOKE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-755-5026"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal New Hope Medical Clinic
• Crystal New Hope Medical Clinic
• Crystal New Hope Medical Clinic Inc
• Crystal Nursing Rehabilitation, LLC
• Crystal Vision Clinic PA
• Christian M Daleiden, M.D.
• Sadiq Datoo, RPH
• Katilyn Marie Davis, CNP
• Jestine Amanda Dennis
• Hellina Tegagne Dessie, D.O.

• Assisted Living Facility in Crystal, MN
• Providers in Crystal, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.