Crystal Dietary Service Inc

LBN: Crystal Dietary Service Inc
Crystal Dietary Service Inc is an health care organization with primary practice located at 15819 Schoolcraft St , Detroit MI 48227-1749. The organization recently has only one registered license in Agencies / Public Health or Welfare, which is considered as the primary health care specialty. Crystal Dietary Service Inc can be contacted via phone (313) 493-4900, or through Mcpherson, Robert via phone (313) 493-4900.

Contact Information

Primary practice address
15819 Schoolcraft St Detroit MI 48227-1749
Phone: (313) 493-4900
Fax: (313) 493-4904
Website:
Map and Directions
Authorized official contact:
Name: Mcpherson, Robert
Phone: (313) 493-4900

Health care specialties

SpecialtyCodeLicense #State
Agencies / Public Health or Welfare 251K00000X

Profile Details

NPI number 1013024017
LBN Legal business name Crystal Dietary Service Inc
DBA Doing business as
Authorized official Mcpherson, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Aug 24th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013024017 NPPES
Michigan MEDICAID 4377557

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