Provider Demographics
NPI:1952998098
Name:CROSSPOINT RESIDENTIAL LLC
Entity Type:Organization
Organization Name:CROSSPOINT RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OFOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-514-3893
Mailing Address - Street 1:7504 MOUNTAIN OAK WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-2731
Mailing Address - Country:US
Mailing Address - Phone:916-514-3893
Mailing Address - Fax:
Practice Address - Street 1:7504 MOUNTAIN OAK WAY
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-2731
Practice Address - Country:US
Practice Address - Phone:916-514-3893
Practice Address - Fax:916-333-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility