CRYSTAL GEM MANOR NPI 1750728812

NPI Information

NPI: 1750728812
Provider Name: CRYSTAL GEM MANOR
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
10845 W GEM ST
CRYSTAL RIVER, FL
ZIP 34428
Phone: (352) 794-7601
Get Directions

CRYSTAL GEM MANOR is an assisted living facility in Crystal River, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. CRYSTAL GEM MANOR NPI is 1750728812. The provider is registered as an organization entity type.

The provider's business location address is:

10845 W GEM ST
CRYSTAL RIVER, FL
ZIP 34428-682
Phone: (352) 794-7601

The provider's authorized official is Jorge A Hernando .
The authorized official title is Owner and has the following contact phone number (305) 868-1830.

The enumeration date for this NPI number is 5/30/2013 and was last updated on 5/30/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		AL10687	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0003517200	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »