Provider Demographics
NPI:1033754676
Name:HANDS AT THE CROSS CARE HOME LLC
Entity Type:Organization
Organization Name:HANDS AT THE CROSS CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIBELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JARDIO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:612-308-1220
Mailing Address - Street 1:1740 OVERLOOK TRL N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-2520
Mailing Address - Country:US
Mailing Address - Phone:612-308-1220
Mailing Address - Fax:
Practice Address - Street 1:1740 OVERLOOK TRL N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-2520
Practice Address - Country:US
Practice Address - Phone:612-308-1220
Practice Address - Fax:651-337-1391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health