CRYSTAL MEADOWS ESTATES, LLC
NPI 1700128428
Custodial Care Facility - Adult Care Home in Wilmington, NC

Q: What is Crystal Meadows Estates, LLC's NPI number?

The NPI number for Crystal Meadows Estates, LLC is 1700128428. It was assigned to this organization in the NPPES registry on March 20, 2013.

Q: What is Crystal Meadows Estates, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Active since March 20, 2013

4173 HEARTHSIDE DRIVE, 104, WILMINGTON, NC 28412(954) 479-9856 Get Directions Write a Review

NPPES record last updated: March 20, 2013. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Crystal Meadows Estates, Llc NPPES

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

CRYSTAL MEADOWS ESTATES, LLC (NPI 1700128428) is a healthcare organization registered as an adult care home in Wilmington, North Carolina and active in the NPI registry since March 2013. The organization lists Johnathaun Lee, Owner, as its authorized official.

NPPES Registry Identity

NPI1700128428

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NameCRYSTAL MEADOWS ESTATES, LLC

Location Address4173 HEARTHSIDE DRIVE, 104Wilmington, NC 28412-8335

Mailing Address4173 Hearthside Drive, 104Wilmington, NC 28412-8335 · (954) 479-9856

Phone(954) 479-9856

Organization SubpartNo

Authorized OfficialJohnathaun LeeOwner · (954) 479-9856

Enumeration DateMarch 20, 2013

✔ NPI 1700128428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities

Taxonomy Code311ZA0620X

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Also ListedIntermediate Care Facility, Mental IllnessTaxonomy 310500000X

4173 HEARTHSIDE DRIVE, Wilmington, NC 28412

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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 Meadows Estates, LLC's NPI number?

The NPI number for Crystal Meadows Estates, LLC is 1700128428. It was assigned to this organization in the NPPES registry on March 20, 2013.

Where is Crystal Meadows Estates, LLC located?

Crystal Meadows Estates, LLC is located at 4173 Hearthside Drive 104, Wilmington, NC 28412. The listed phone number is (954) 479-9856.

What is Crystal Meadows Estates, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Crystal Meadows Estates, LLC was last updated on March 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.