CRYSTAL CARE CENTER OF MANSFIELD INC. (NPI# 1720123318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720123318 |
| Entity Type | Organization |
| Organization Name | CRYSTAL CARE CENTER OF MANSFIELD INC. |
| Practice Address |
1159 Wyandotte Ave. Mansfield OH 44906-1940 |
| Mailing Address |
1159 Wyandotte Ave Mansfield OH 44906-1940 |
| Practice Telephone | 4197472666 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JERRY SMITH (OWNER) |
| Authorized Official Telephone | 4197472666 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | OH | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0387693 | 05 |
| Street Address |
1159 WYANDOTTE AVE. |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44906-1940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920155 | Jonathan Clevenger | Pharmacist | 1455 North Lexington-springmill Road, Ontario, OH 44906 | 2020-10-21 |
| 1366083297 | Jennifer Robin Young | Technician | 60 Sherman Ave, Mansfield, OH 44906 | 2019-10-02 |
| 1639721905 | Lora Harris | Nurse Practitioner | 1029 S. Trimble Rd, Mansfield, OH 44906 | 2019-07-16 |
| 1871098855 | Med Gear Plus, LLC | Durable Medical Equipment & Medical Supplies | 1041 Park Ave W, Mansfield, OH 44906 | 2018-03-29 |
| 1912401209 | Bradley Anderson | Dietitian, Registered | 1025 South Trimble Rd., Mansfield, OH 44906 | 2018-03-21 |
| 1104325182 | Nancy Labaki | Speech-Language Pathologist | 2011 W. Fourth St., Mansfield, OH 44906 | 2018-02-06 |
| 1720518319 | Stephen Anderson | Counselor | 680 Park Ave W., Mansfield, OH 44906 | 2017-06-15 |
| 1427422518 | Jill A Waite | Counselor | 33 S. Lexington-springmill Road, Mansfield, OH 44906 | 2015-11-30 |
| 1992125397 | Taryn Boyd | Physical Therapist | 1025 S Trimble, Mansfield, OH 44906 | 2014-04-24 |
| 1356760870 | Sarah Brandyberry | Social Worker | 1025 S. Trimble Rd., Mansfield, OH 44906 | 2014-04-11 |
| Find all providers in zip 44906 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710378575 | Mansfield Long Term Care LLC | Skilled Nursing Facility | 2100 Cannon Drive, Mansfield, TX 76063 | 2015-02-13 |
| 1922309962 | Mansfield Snf LLC | Skilled Nursing Facility | 200 E. Debbie Lane, Mansfield, TX 76063 | 2010-11-08 |
| 1073687752 | Healthcare Ventures of Ohio LLC | Skilled Nursing Facility | 1670 Crider Rd, Mansfield, OH 44903-9268 | 2006-11-17 |
| 1124199849 | Northern Health Facilities, Inc. | Skilled Nursing Facility | 1600 Crider Rd, Mansfield, OH 44903-9268 | 2006-11-13 |
| 1942308861 | J-s Mansfield Operations, Lp | Skilled Nursing Facility | 301 N Miller Rd, Mansfield, TX 76063 | 2006-09-21 |
| 1538182654 | N & R of Mansfield, LLC | Skilled Nursing Facility | 3111 Highway A, Mansfield, MO 65704-8105 | 2006-07-26 |
| 1821018649 | Mansfield Memorial Homes, Inc | Skilled Nursing Facility | 50 Blymyer Ave, Mansfield, OH 44903-2343 | 2006-07-21 |
| 1174506075 | Levering Management, Inc. | Skilled Nursing Facility | 70 Winchester Rd, Mansfield, OH 44907-2042 | 2005-11-23 |
| 1396728739 | Desoto Retirement & Rehab Center, LLC | Skilled Nursing Facility | 635 Schley St, Mansfield, LA 71052-3820 | 2005-11-21 |
| 1346223708 | Mansfield Nursing Center, L.L.C. | Skilled Nursing Facility | 1725 Mcarthur Dr, Mansfield, LA 71052-4501 | 2005-11-21 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.