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General NPI Number Information
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NPI Number | 1457359838
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Entity Type | Organization
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Legal Business Name | CROSSROADS REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 4740 KINGSWAY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-1521
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Country | US
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Telephone | 317-466-1000
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Fax | 317-466-2000
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Provider Business Mailing Address
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Address Line | 4740 KINGSWAY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-1521
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Country | US
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Telephone | 317-466-1000
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Fax | 317-466-2000
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES PATRICK SANDY
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Credential |
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Telephone | 317-466-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225XR0403X
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Taxonomy Name | Driving and Community Mobility Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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