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General NPI Number Information
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NPI Number | 1225327356
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Entity Type | Organization
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Legal Business Name | CROSSROADS HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 1201 WEAVER RD
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City | HERRIN
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State | IL
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Zip | 62948-2621
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Country | US
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Telephone | 618-988-1840
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Fax | 618-988-8623
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Provider Business Mailing Address
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Address Line | 1201 WEAVER RD
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City | HERRIN
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State | IL
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Zip | 62948-2621
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Country | US
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Telephone | 618-988-1840
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Fax | 618-988-8623
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Authorized Official
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Title or Position | DIR. BUSSINESS OFFICE SUPPORT
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | IL
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