Healthcare Provider Details

I. General information

NPI: 1104674811
Provider Name (Legal Business Name): CROSS COUNTRY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 E SOUTHERN AVE
MESA AZ
85206-2569
US

IV. Provider business mailing address

2910 N SWAN RD STE 203
TUCSON AZ
85712-6011
US

V. Phone/Fax

Practice location:
  • Phone: 480-696-6420
  • Fax:
Mailing address:
  • Phone: 480-696-6420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DAN MASSERMAN
Title or Position: PRESIDENT
Credential:
Phone: 855-507-7041