{
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"OrgName": "CROSSROADS HOME CARE SERVICES, LLC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "1201 WEAVER RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HERRIN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "62948-2621",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "618-988-1840",
"MailingAddressFaxNumber": "618-988-8623",
"FirstLinePracticeLocationAddress": "1201 WEAVER RD",
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"PracticeLocationAddressCityName": "HERRIN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "618-988-1840",
"PracticeLocationAddressFaxNumber": "618-988-8623",
"EnumerationDate": "03/29/2011",
"LastUpdateDate": "10/24/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOLTSFORD",
"AuthorizedOfficialFirstName": "LAURIE",
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"AuthorizedOfficialTitle": "DIR. BUSSINESS OFFICE SUPPORT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "615-465-7466",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}