NPIMap

Organization Active NPI

Crossroads Living Center, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Fairfield, CA
National Provider Identifier
1083882658
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
CROSSROADS LIVING CENTER, INC.
Practice address
325 Honeysuckle Dr
Fairfield, CA 94533-1124
Phone
(707) 449-9377
NPI assigned
Feb 15, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Sara Jane Dutra
Title
Bookkeeper
Phone
(530) 532-7889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X CA Primary

Addresses

Primary practice location

325 Honeysuckle Dr
Fairfield, CA 94533-1124

Mailing address

320 Cernon St
Vacaville, CA 95688-4502
Phone (707) 449-9377

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Living Center Inc3 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": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1083882658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CERNON ST",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884502",
            "telephone_number": "707-449-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HONEYSUCKLE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945331124",
            "telephone_number": "707-449-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS LIVING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "DUTRA",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "530-532-7889"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.