CRYSTAL RAE WILSON
NPI 1477279446
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Shade, OH

Q: What is Crystal Wilson's NPI number?

The NPI number for Crystal Wilson is 1477279446. It was assigned to this individual provider in the NPPES registry on October 12, 2022.

Q: What is Crystal Wilson's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Q: When was this NPI record last updated?

The NPPES record for Crystal Wilson was last updated on October 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 12, 2022

40328 BURLINGHAM RD, SHADE, OH 45776(740) 590-9205 Get Directions Write a Review

NPPES record last updated: October 12, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Crystal Rae Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL RAE WILSON (NPI 1477279446) is an individual community based residential treatment facility, intellectual and/or developmental disabilities provider in Shade, Ohio and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1477279446

Entity TypeIndividualFemale

Primary Taxonomy320900000X

Provider Legal NameCRYSTAL RAE WILSON

Location Address40328 BURLINGHAM RDShade, OH 45776-9505

Mailing Address40328 Burlingham RdShade, OH 45776-9505 · (740) 590-9205

Phone(740) 590-9205

Sole ProprietorYes

Enumeration DateOctober 12, 2022

NPPES CertifiedOctober 12, 2022

✔ NPI 1477279446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

40328 BURLINGHAM RD, Shade, OH 45776

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Other Identifiers 1

Medicaid0000307788OH

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Wilson's NPI number?

The NPI number for Crystal Wilson is 1477279446. It was assigned to this individual provider in the NPPES registry on October 12, 2022.

Where is Crystal Wilson located?

Crystal Wilson practices at 40328 Burlingham Rd, Shade, OH 45776. The listed phone number is (740) 590-9205.

What is Crystal Wilson's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Crystal Wilson was last updated on October 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.