Crystal Care Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CRYSTAL CARE SERVICES

Practice address

2104 Park Ave
Minneapolis, MN 55404-6607

Phone

(612) 999-0240

NPI assigned

Jul 28, 2022

Last updated

Jan 6, 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

Nimo Shariff Mohamed

Title

Owner

Phone

(612) 999-0240

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1902532351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554046607",
            "telephone_number": "612-999-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554046607",
            "telephone_number": "612-999-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "NIMO",
        "authorized_official_middle_name": "SHARIFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-999-0240"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reyna M Cruz
• Treana Danielle Cruz, LICSW
• Amanda Cruze, OTR.L
• Tim Cryer
• Crystal Care & Rehabilitation Center, LLC (Crystal Care Center)
• Luis Alberto Cuadrado Miranda
• Austin Cudak
• Terefech Elias Cudd-Zamora
• Veronica Cudo
• Sylvia Maria Cuellar, D.D.S

• Mental Health Clinic/Center (Including Community Mental Health Center) in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.