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General NPI Number Information
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NPI Number | 1124253356
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Entity Type | Organization
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Legal Business Name | CROSSROADS UNLIMITED, LLC
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 201 CRESCENT RD
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City | WINSTON SALEM
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State | NC
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Zip | 27105-1712
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Country | US
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Telephone | 240-601-0511
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11739
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City | WINSTON SALEM
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State | NC
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Zip | 27116-1739
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | TONYA L MITCHELL
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Credential | RN
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Telephone | 240-601-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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