Provider Demographics
NPI:1831687649
Name:CROSSROADS HOME CARE, LLC
Entity type:Organization
Organization Name:CROSSROADS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-325-6979
Mailing Address - Street 1:2851 S PARKER RD STE 500
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2726
Mailing Address - Country:US
Mailing Address - Phone:720-364-5172
Mailing Address - Fax:720-208-0607
Practice Address - Street 1:2851 S PARKER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2736
Practice Address - Country:US
Practice Address - Phone:720-364-5172
Practice Address - Fax:720-208-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care