| NPI | 1982291316 |
|---|---|
| Former Legal Business Name | CRISTAL PROVIDER SERVICES, LLC. |
| Entity Type | Organization |
| Authorized Contact | ROY GONZALEZ CEO 956-735-3341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2020-12-31 |
| Last Update Date | 2024-02-13 |