Provider Demographics
NPI:1366411712
Name:CROSSROADS HOME HEALTH,INC
Entity type:Organization
Organization Name:CROSSROADS HOME HEALTH,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SPICAK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-578-2436
Mailing Address - Street 1:1910 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5598
Mailing Address - Country:US
Mailing Address - Phone:361-578-2436
Mailing Address - Fax:361-578-5571
Practice Address - Street 1:1910 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5598
Practice Address - Country:US
Practice Address - Phone:361-578-2436
Practice Address - Fax:361-578-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1038370001Medicare NSC