Crossroad - Fort Wayne Childrens Home in Fort Wayne - Adolescent And Children Mental Health
Crossroad - Fort Wayne Childrens Home - NPI 1275614109
Crossroad - Fort Wayne Childrens Home is a Adolescent And Children Mental Health in Fort Wayne, Indiana. Crossroad - Fort Wayne Childrens Home practices all healthcare services and medical treatments related to Adolescent And Children Mental Health. The NPI Number for Crossroad - Fort Wayne Childrens Home is 1275614109. The last update date is 2020-08-22.
Crossroad - Fort Wayne Childrens Home's current location address is 2525 Lake Ave, Fort Wayne, Indiana. You can contact this provider via phone number 2604844153. The mailing address for Crossroad - Fort Wayne Childrens Home is 2525 Lake Ave, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Crossroad - Fort Wayne Childrens Home |
|---|---|
| Address | 2525 Lake Ave, Fort Wayne, Indiana |
| Phone Number | 2604844153 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO/PRESID |
|---|---|
| Authorized Official Name | Dollar Jc |
| Telephone Number | 2604844153 |
NPI Number Detail
| NPI Number | 1275614109 |
|---|---|
| Provider Enumeration Date | 2006-10-18 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 2525 Lake Ave |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468055407 |
| Phone Number | 2604844153 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent And Children Mental Health |
|---|---|
| Taxonomy | 261Qm0855X |
| Licence No | 734260290083 |
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Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patie |
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What is the unique identifier code issued to Crossroad - Fort Wayne Childrens Home by the Centers for Medicare & Medicaid Services?
The Crossroad - Fort Wayne Childrens Home has been assigned the NPI (National Provider Identifier) 1275614109. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Crossroad - Fort Wayne Childrens Home?
The Crossroad - Fort Wayne Childrens Home is physically situated at 2525 Lake Ave, in the city of Fort Wayne, state of IN, with the postal code 468055407.
What is Crossroad - Fort Wayne Childrens Home's specialized field of practice, and what is the corresponding taxonomy classification code?
The Crossroad - Fort Wayne Childrens Home's area of specialization is Adolescent And Children Mental Health, and the corresponding taxonomy code that categorizes this field of practice is 261Qm0855X.
When was the Crossroad - Fort Wayne Childrens Home's 1275614109 issued?
The Crossroad - Fort Wayne Childrens Home's 1275614109 was issued on 2006-10-18.
As of what date were the details related to Crossroad - Fort Wayne Childrens Home most recently updated or revised?
The information pertaining to Crossroad - Fort Wayne Childrens Home, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.