CROSSROAD CHILD & FAMILY SERVICES INC. NPI 1699868893

NPI Information

NPI: 1699868893
Provider Name: CROSSROAD CHILD & FAMILY SERVICES, INC.
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
1825 BEACON STREET
FORT WAYNE, IN
ZIP 46805
Phone: (260) 484-4153
Get Directions

CROSSROAD CHILD & FAMILY SERVICES, INC. is a residential treatment facility emotionally disturbed children in Fort Wayne, IN. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CROSSROAD CHILD & FAMILY SERVICES, INC. NPI is 1699868893. The provider is registered as an organization entity type.

The provider's business location address is:

1825 BEACON STREET
FORT WAYNE, IN
ZIP 46805
Phone: (260) 484-4153
Fax: (260) 484-2337

The provider's authorized official is David Mullins .
The authorized official title is President/ceo and has the following contact phone number (260) 484-4153.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 2/14/2024.

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	323P00000X	Psychiatric Residential Treatment Facility		3001702900002	INDIANA	No
2	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		3001702900002	INDIANA	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	200295210	MEDICAID	INDIANA

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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