MEDICARE: CROSSPOINT RESIDENTIAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility
2	3104A0625X	Assisted Living Facility (Mental Illness)

General Provider Information

NPI Number	:	1235885476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSPOINT RESIDENTIAL LLC

Provider Business Mailing Address
First Line	:	6921 WOODSIDE DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95842-2228
Country	:	US
Telephone Number	:	916-676-2631
Fax Number	:

Provider Business Practice Location Address
First Line	:	5910 LA CASTANA WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5621
Country	:	US
Telephone Number	:	408-373-7750
Fax Number	:

Authorized Official
Title or Position	:	OWNER ADMIN
Name	:	PATRICK OFOSE
Credential	:
Telephone Number	:	408-373-7750

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	05/23/2024

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Directions to “CROSSPOINT RESIDENTIAL LLC ” Practice Location

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