NPIMap

Organization Active NPI

Crosstree Healthcare LLC

  • Assisted Living Facility
  • Kennett, MO
National Provider Identifier
1063188035
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
CROSSTREE HEALTHCARE LLC
Practice address
612 South Byp
Kennett, MO 63857-3240
Phone
(573) 217-8669
NPI assigned
Aug 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Scott Cole
Title
Owner
Phone
(573) 217-8669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

612 South Byp
Kennett, MO 63857-3240

Mailing address

2061 Magnolia Dr
Piggott, AR 72454-3129
Phone (573) 217-8669

Other names 1

  • Southaven Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crosstree Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1063188035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 MAGNOLIA DR",
            "city": "PIGGOTT",
            "state": "AR",
            "postal_code": "724543129",
            "telephone_number": "573-217-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SOUTH BYP",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573240",
            "telephone_number": "573-217-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSTREE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-217-8669"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southaven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.