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NPI Code Detail

MEDICARE: CROSSROADS REHABILITATION CENTER, INC.

MEDICARE: CROSSROADS REHABILITATION CENTER, INC.
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
1208100000XPhysical Medicine & Rehabilitation Physician
2103K00000XBehavior Analyst
3101YM0800XMental Health Counselor
4225100000XPhysical Therapist
5225X00000XOccupational Therapist
6225XR0403XDriving and Community Mobility Occupational Therapist
7235Z00000XSpeech-Language Pathologist
8225400000XRehabilitation Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457359838
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSROADS REHABILITATION CENTER, INC.
Provider Business Mailing Address
First Line : 4740 KINGSWAY DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1521
Country : US
Telephone Number : 317-466-1000
Fax Number : 317-466-2000
Provider Business Practice Location Address
First Line : 4740 KINGSWAY DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1521
Country : US
Telephone Number : 317-466-1000
Fax Number : 317-466-2000
Authorized Official
Title or Position : PRESIDENT
Name : MR. JAMES PATRICK SANDY
Credential :
Telephone Number : 317-466-2015
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/30/2013

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Directions to “CROSSROADS REHABILITATION CENTER, INC. ” Practice Location

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