CROSSROADS HOSPICE OF DAYTON LLC NPI 1679741128

NPI Information

NPI: 1679741128
Provider Name: CROSSROADS HOSPICE OF DAYTON LLC

Other Name: CROSSROADS HOSPICE AND PALLIATIVE CARE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 36D2006104

Address:
8069 WASHINGTON VILLAGE DR
DAYTON, OH
ZIP 45458
Phone: (937) 312-3170
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CROSSROADS HOSPICE OF DAYTON LLC is a hospice care community based in Dayton, OH. CROSSROADS HOSPICE OF DAYTON LLC NPI is 1679741128. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Crossroads Hospice And Palliative Care.

The provider's business location address is:

8069 WASHINGTON VILLAGE DR
DAYTON, OH
ZIP 45458-847
Phone: (937) 312-3170
Fax: (937) 439-5903

The provider's authorized official is Clayton Farmer .
The authorized official title is Cfo/coo and has the following contact phone number (918) 627-6846.

The CLIA number assigned to this NPI record is 36D2006104 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2008 and was last updated on 11/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QH0002X	Family Medicine	Hospice and Palliative Medicine			No
2	251G00000X	Hospice Care, Community Based		0168HSP	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3133120	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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