Provider Demographics
NPI:1366074882
Name:CROSS POINT ADULT RESIDENTIAL CARE
Entity type:Organization
Organization Name:CROSS POINT ADULT RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:LAVELLE
Authorized Official - Last Name:KERR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:620-717-2339
Mailing Address - Street 1:848 E LANESFIELD ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-1937
Mailing Address - Country:US
Mailing Address - Phone:913-938-4956
Mailing Address - Fax:
Practice Address - Street 1:2914 N 38TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-2526
Practice Address - Country:US
Practice Address - Phone:620-717-2339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities