| NPI | 1336577808 |
|---|---|
| Doing Business As | CRYSTAL LAKE HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | CHAVIE KATZ Billing Manager 718-567-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2015-07-01 |