Provider Demographics
NPI:1295965903
Name:CROSSROADS HEALTHCARE INC
Entity type:Organization
Organization Name:CROSSROADS HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-921-5817
Mailing Address - Street 1:1111 MAIN ST
Mailing Address - Street 2:SUITE 555
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-2990
Mailing Address - Country:US
Mailing Address - Phone:360-433-9375
Mailing Address - Fax:360-828-5316
Practice Address - Street 1:1111 MAIN ST
Practice Address - Street 2:SUITE 555
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2990
Practice Address - Country:US
Practice Address - Phone:360-433-9375
Practice Address - Fax:360-828-5316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602915599000251F00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care