Crystal White
Custodial Care Facility, Adult Care Home in Tucker, GA. Individual provider (NPI-1).
NPI number1982241758
StatusActive
Last updated in NPPESNov 6, 2026
Details
- NPI
- 1982241758
- Entity type
- Individual (NPI-1)
- Name
- Crystal White
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 29, 2019
- Certification date
- Nov 6, 2026
- Last updated
- Nov 6, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | GA | Yes |
| 374U00000X | Home Health Aide | 044-R-2070 | GA |
Practice location
3818 Northlake Creek DrTucker, GA 30084-3418
Phone 404-988-8811
Mailing address
3818 Northlake Creek DrTucker, GA 30084-3418
Phone 404-988-8811
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Other Adult Care Home Facility providers in Tucker, GA
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