Cross Creek Care, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

306000888 Issued in CA

Legal business name

CROSS CREEK CARE, INC

Practice address

138 E 18TH St
Costa Mesa, CA 92627-3035

Phone

(949) 722-1014

Fax

(949) 631-5205

NPI assigned

Mar 15, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Winfred Wilson, RN

Title

Owner/Administrator

Phone

(949) 722-1014

Specialties & licenses 1

Addresses

Other names 1

• Cross Creek Cottage Other name

Locations

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

{
    "created_epoch": "1426377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426377600000",
    "number": "1144613142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 E 18TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273035",
            "telephone_number": "949-722-1014",
            "fax_number": "949-631-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 E 18TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273035",
            "telephone_number": "949-722-1014",
            "fax_number": "949-631-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CREEK CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-15",
        "last_updated": "2015-03-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WINFRED",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "949-722-1014",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "306000888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Creek Cottage",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Creative Solutions for Autism, Inc.
• Stefani Crecelius
• Daniel Nicholas Crespo
• Felicia Chanelle Crocker
• Brian Edward Croner, BS
• Cross Creek Manor Inc.
• Jasmine Marie Cross
• Karen Crouch, CHT
• Erin Kathleen Crowley, MASTERS OF SCIENCE
• Katie Croy

• Assisted Living Facility in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.