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Contact Information

CROSSROADS 1010 LLC
193908 US HWY 271
ANTLERS, OK74523
 Phone: 580-271-7080
 Fax: 580-298-2081
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for CROSSROADS 1010 LLC

NPI # 1174072482
LBN Legal business name CROSSROADS 1010 LLC
Authorized official JENNIFER GRIFFIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/27/2016
Last updated 11/27/2018 - About 8 years ago
Identifiers
OK Medicaid 200734990A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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