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Organization

CROSSROAD CHILD & FAMILY SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID MULLINS (PRESIDENT/CEO)
(260) 484-4153
Entity
Organization

Contact information

Practice address
1825 BEACON STREET, FORT WAYNE, IN 46805
(260) 484-4153
(260) 484-2337
Mailing address
1825 BEACON STREET, FORT WAYNE, IN 46805
(260) 484-4153
(260) 484-2337

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
3001702900002
IN
323P00000X
Psychiatric Residential Treatment Facility
3001702900002
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200295210
IN
Enumeration date
10/02/2006
Last updated
02/14/2024
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