Provider Demographics
NPI:1174840227
Name:CROSS POINTE CARE
Entity Type:Organization
Organization Name:CROSS POINTE CARE
Other - Org Name:CROSS POINTE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPOUDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-367-4597
Mailing Address - Street 1:4700 SHERIDAN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3420
Mailing Address - Country:US
Mailing Address - Phone:954-927-0508
Mailing Address - Fax:954-927-3127
Practice Address - Street 1:440 PHIPPEN WAITERS RD
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-4931
Practice Address - Country:US
Practice Address - Phone:954-927-0508
Practice Address - Fax:954-927-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105296Medicare Oscar/Certification