Crossroads Care Center of Crystal River LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CROSSROADS CARE CENTER OF CRYSTAL RIVER LLC

Practice address

1401 Churchill St
Waupaca, WI 54981-2027

Phone

(715) 258-8131

Fax

(715) 258-0179

NPI assigned

Mar 9, 2015

Last updated

Jan 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Merzel

Title

Cfo

Phone

(847) 983-4860

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1093108565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CHURCHILL ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812027",
            "telephone_number": "715-258-8131",
            "fax_number": "715-258-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CHURCHILL ST",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812027",
            "telephone_number": "715-258-8131",
            "fax_number": "715-258-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS CARE CENTER OF CRYSTAL RIVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "MERZEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-983-4860"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy S Connor, LCSW
• Alicia L Cook, SAC
• County of Waupaca (Waupaca County Dept of Human Services)
• County of Waupaca (Waupaca County Dept of Human Services)
• Stephanie Jean Crane, LCSW
• Crystal River Dental, LLC
• Cody W Dagnall, OD
• Ismail A Dania, MD
• Daniel L. Gauerkei Dba Broadway Vision Center (Broadway Vision Center)
• Tracy Marie Darnutzer, OTR

• Skilled Nursing Facility in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.