Provider Demographics
NPI:1235841040
Name:CROSSLINKS GROUP HOME LLC
Entity Type:Organization
Organization Name:CROSSLINKS GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FOLAKE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-202-6672
Mailing Address - Street 1:989 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1444
Mailing Address - Country:US
Mailing Address - Phone:973-202-6672
Mailing Address - Fax:973-762-4140
Practice Address - Street 1:989 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1444
Practice Address - Country:US
Practice Address - Phone:973-202-6672
Practice Address - Fax:973-762-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities