Organization
CROSSTOWN FAMILY CARE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELLIE JOHNSON (DIRECTOR)
(954) 667-5616
Entity
Organization
Contact information
Practice address
1850 SW MACKENZIE ST, PORT ST LUCIE, FL 34953-1329
(954) 667-5616
(772) 333-2894
Mailing address
1850 SOUTHWEST MACKENZIE STREET, PORT ST LUCIE, FL 34953-1329
(954) 667-5616
(772) 333-2894
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
311Z00000X
Custodial Care Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
678513
—
FL
Enumeration date
09/01/2016
Last updated
09/25/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up