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General NPI Number Information
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NPI Number | 1750209474
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Entity Type | Organization
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Legal Business Name | INDIANA CROSSROADS COMMUNITY SERVICES
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 8133 FAWNSBROOK DR
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City | FISHERS
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State | IN
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Zip | 46038-1028
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Country | US
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Telephone | 765-426-4993
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Fax |
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Provider Business Mailing Address
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Address Line | 8133 FAWNSBROOK DR
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City | FISHERS
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State | IN
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Zip | 46038-1028
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Country | US
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Telephone | 765-426-4993
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JASON ROBERT WEISENBACH
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Credential |
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Telephone | 765-426-4993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 385H00000X
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Taxonomy Name | Respite Care
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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 | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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