Crossroad Child and Family Services, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

CROSSROAD CHILD AND FAMILY SERVICES, INC.

Practice address

2525 Lake Ave
Fort Wayne, IN 46805-5407

Phone

(260) 484-4153

NPI assigned

Mar 24, 2012

Organization subpart

No

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

Authorized official

Name

Christy Bradley

Title

Finance

Phone

(260) 484-4153

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332547200000",
    "number": "1689940678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055407",
            "telephone_number": "260-484-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROAD CHILD AND FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-24",
        "last_updated": "2012-03-24",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "FINANCE",
        "authorized_official_telephone_number": "260-484-4153"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Illness Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2012; 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.