NPIMap

Organization Active NPI

Mt Enterprise Community Health Clinic

Doing business as Crossroads Family Care

  • Federally Qualified Health Center (FQHC)
  • Palestine, TX
National Provider Identifier
1043741275
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MT ENTERPRISE COMMUNITY HEALTH CLINIC
Doing business as
Crossroads Family Care
Practice address
4002 S Loop 256 Ste K
Palestine, TX 75801-8402
Phone
(903) 729-3015
Fax
(903) 729-2738
NPI assigned
Mar 21, 2017
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MT ENTERPRISE COMMUNITY HEALTH CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Becky Eldridge
Title
Ceo
Phone
(903) 392-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X TX Primary

Addresses

Primary practice location

4002 S Loop 256 Ste K
Palestine, TX 75801-8402

Mailing address

PO Box 489
Mt Enterprise, TX 75681-0489
Phone (903) 729-3015

Other names 1

  • Crossroads Family Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110801000150 TX Part B Supplier - Clinic/Group Practice 2860303922 Receives reassigned benefits from 12 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Henderson, TX; Mt. Enterprise, TX; Palestine, TX
O20170719003461 TX Part A Provider - Federally Qualified Health Center (FQHC) 2860303922 Practice locations: Palestine, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043741275. Details of each certification follow.

Federally qualified health center certification: CCN 741969

Legal name
MT ENTERPRISE COMMUNITY HEALTH CLINIC
Doing business as
CROSSROADS FAMILY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 25, 2017
Last certification
Sep 25, 2017
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jul 21, 2003 in TX
Enrollment address
4002 S Loop 256
Ste K
Palestine, TX 75801-8402

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mt Enterprise Community Hea4 organizations share this tax ID, including this one
Part of
Mt Enterprise Community Hea

Other organizations with this tax ID 3

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

Locations

4002 S Loop 256
Ste K
Palestine, TX 75801
Phone (903) 723-0600

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Grubbs Individual Corporate DirectorBoard of Directors Sep 19, 2013
Jean Williams Individual Corporate DirectorBoard Member May 15, 2015
Patsy Fogleman Individual Corporate DirectorBoard Member Jun 6, 2014
Jestin Stowe Individual Corporate OfficerCeo, Sep 16, 2022
Becky Eldridge Individual Corporate DirectorBoard of Director VP Oct 24, 2012
Leo Gonzalez Individual Corporate DirectorBoard of Directors President Mar 29, 2012
Harvey L Graves Individual Corporate DirectorBoard Member Jul 1, 2009
Yolanda Deleon Individual Corporate OfficerBoard Member Secretary Feb 21, 2021
Michelle Simmons Individual Corporate DirectorBoard Member Treasurer Oct 21, 2016
Roslyn Grigsby Individual Operational/Managerial ControlBilling / Credentialing Coordinator Jan 1, 2013

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1043741275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "MT ENTERPRISE",
            "state": "TX",
            "postal_code": "756810489",
            "telephone_number": "903-729-3015",
            "fax_number": "903-205-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 S LOOP 256 STE K",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758018402",
            "telephone_number": "903-729-3015",
            "fax_number": "903-729-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT ENTERPRISE COMMUNITY HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MT ENTERPRISE COMMUNITY HEALTH CLINIC",
        "enumeration_date": "2017-03-21",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "ELDRIDGE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-392-8203"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.