Crystal Care Support Services, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

21157 Issued in MN

Legal business name

CRYSTAL CARE SUPPORT SERVICES, INC

Practice address

6461 Lyndale Ave S
Richfield, MN 55423-1405

Phone

(612) 861-4272

Fax

(612) 866-2290

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Sally Knutson, RN, MA

Title

Administrator

Phone

(612) 861-4272

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891735627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6461 LYNDALE AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231405",
            "telephone_number": "612-861-4272",
            "fax_number": "612-866-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6461 LYNDALE AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231405",
            "telephone_number": "612-861-4272",
            "fax_number": "612-866-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CARE SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNUTSON",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-861-4272",
        "authorized_official_credential": "RN, MA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "21157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS A LICENSE",
            "identifier": "21157",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Richfield, MN
• Providers in Richfield, MN by specialty
• Home Health Agency in Minnesota

• 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.