Healthcare Provider Details

I. General information

NPI: 1265362396
Provider Name (Legal Business Name): CROSSROADS CARING MISSION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 W MAIN ST
MERCED CA
95340-4932
US

IV. Provider business mailing address

1635 LACAVA RD
MERCED CA
95348-9202
US

V. Phone/Fax

Practice location:
  • Phone: 408-854-2004
  • Fax:
Mailing address:
  • Phone: 408-854-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. KHIT PHOMMAVANH
Title or Position: FOUNDER / EXECUTIVE DIRECTOR
Credential:
Phone: 408-854-2004