Crossroad Landing Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

1047494-1-AFC Issued in MN

Legal business name

CROSSROAD LANDING INC

Practice address

502 Glenwood Ave
Cloquet, MN 55720-1208

Phone

(218) 499-4030

Fax

(952) 400-8950

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Dennis Ervin Ellefson

Title

Vice President

Phone

(218) 499-4030

Specialties & licenses 1

Addresses

Other names 1

• Crossroad Landing Other name

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871700765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 GLENWOOD AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201208",
            "telephone_number": "218-499-4030",
            "fax_number": "952-400-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 GLENWOOD AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201208",
            "telephone_number": "218-499-4030",
            "fax_number": "952-400-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROAD LANDING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLEFSON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "ERVIN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "218-499-4030"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "1047494-1-AFC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroad Landing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• County of Carlton (Carlton County Public Health & Human Services)
• County of Carlton (Carlton County Public Health)
• County of Carlton (Carlton County Human Services)
• County of Carlton Ind School Dist 95
• County of Carlton/Wrenshall Isd #100
• McKala Kaitlin Crotteau
• Joseph Curran
• Mya Marie Cuypers
• Daniel Patrick D'Allaird, LP
• Valerie Dahl

• Adult Care Home Facility in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.