Healthcare Provider Details
I. General information
NPI: 1801673264
Provider Name (Legal Business Name): CROSS COUNTRY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2023
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2910 N SWAN RD STE 203
TUCSON AZ
85712-6011
US
IV. Provider business mailing address
2910 N SWAN RD STE 203
TUCSON AZ
85712-6011
US
V. Phone/Fax
- Phone: 520-333-4933
- Fax:
- Phone: 520-333-4933
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAN
MASSERMAN
Title or Position: PRESIDENT
Credential:
Phone: 855-507-7041