NPIMap

Organization Active NPI

Crossroad Child and Family Services

  • Mental Illness Community Based Residential Treatment Facility
  • Fort Wayne, IN
National Provider Identifier
1033599014
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
35001873A Issued in IN
Legal business name
CROSSROAD CHILD AND FAMILY SERVICES
Practice address
2525 Lake Ave
Fort Wayne, IN 46805-5407
Phone
(260) 484-4153
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashlee Rager
Title
Therapist
Phone
(260) 484-4153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 35001873A IN Primary

Addresses

Primary practice location

2525 Lake Ave
Fort Wayne, IN 46805-5407

Mailing address

2525 Lake Avenue
Fort Wayne, IN 46805

National Provider Directory

National Provider Directory
Tax ID family
Crossroad Child and Family Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1033599014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 LAKE AVENUE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055407",
            "telephone_number": "260-484-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROAD CHILD AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "RAGER",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "260-484-4153"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IN",
            "license": "35001873A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.