Provider Demographics
NPI:1215909296
Name:CROSSING THE JORDAN CHRISTIAN HEALTH CENTER, INC.
Entity type:Organization
Organization Name:CROSSING THE JORDAN CHRISTIAN HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-222-7159
Mailing Address - Street 1:289 E BEAU ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4710
Mailing Address - Country:US
Mailing Address - Phone:724-222-7159
Mailing Address - Fax:724-222-7169
Practice Address - Street 1:289 E BEAU ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4710
Practice Address - Country:US
Practice Address - Phone:724-222-7159
Practice Address - Fax:724-222-7169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066408L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care