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NPI Code Detail

MEDICARE: CROSSROADS HOME CARE, INC.

MEDICARE: CROSSROADS HOME CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyIN

General Provider Information

NPI Number : 1023222684
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSROADS HOME CARE, INC.
Provider Business Mailing Address
First Line : 576 OLDS ST
Second Line :
City : JONESVILLE
State : MI
Zip : 49250-9475
Country : US
Telephone Number : 260-665-7123
Fax Number : 260-665-7256
Provider Business Practice Location Address
First Line : 100 GROWTH PKWY
Second Line : SUITE E
City : ANGOLA
State : IN
Zip : 46703-9343
Country : US
Telephone Number : 260-665-7123
Fax Number : 260-665-7256
Authorized Official
Title or Position : VICE-PRESIDENT
Name : MRS. BRANDIE E. LANDIS
Credential :
Telephone Number : 260-665-7123
Provider Enumeration Date : 05/10/2007
Last Update Date : 08/22/2020

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