Provider Demographics
NPI:1760601819
Name:CROSSROADS HEALTH CARE LLC
Entity Type:Organization
Organization Name:CROSSROADS HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEIZER
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:816-383-1466
Mailing Address - Street 1:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64502-0051
Mailing Address - Country:US
Mailing Address - Phone:816-383-1466
Mailing Address - Fax:816-369-2103
Practice Address - Street 1:20731 STATE ROUTE V
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MO
Practice Address - Zip Code:64459-9109
Practice Address - Country:US
Practice Address - Phone:816-383-1466
Practice Address - Fax:816-369-2103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROSSROADS HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-25
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0009181163W00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty