Organization
CROSSROAD CHILD AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEE RAGER (THERAPIST)
(260) 484-4153
Entity
Organization
Contact information
Practice address
2525 LAKE AVE, FORT WAYNE, IN 46805-5407
(260) 484-4153
Mailing address
2525 LAKE AVENUE, FORT WAYNE, IN 46805
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
35001873A
IN
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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