CROSSROAD CHILD AND FAMILY SERVICES, INC.
NPI 1689940678
Community Based Residential Treatment Facility, Mental Illness in Fort Wayne, IN
NPI Status: Active since March 24, 2012
- Organization
- Community Based Residential Treatment Fa...
- CLIA Number: 15D2026190
- CLIA Cert. Type: Other - INPATIENT RESIDENTIAL PSY
- CLIA Exp. Date: 06-26-2025
About CROSSROAD CHILD AND FAMILY SERVICES, INC.
This page provides the complete NPI Profile along with additional information for Crossroad Child And Family Services, Inc., a provider established in Fort Wayne, Indiana operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1689940678 assigned on March 2012. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Christy Bradley (Finance)
- NPI
- 1689940678
- Provider Name
- CROSSROAD CHILD AND FAMILY SERVICES, INC.
- Entity Type
- Organization
- Location Address
- 2525 LAKE AVE FORT WAYNE, IN 46805
- Location Phone
- (260) 484-4153
- Mailing Address
- 2525 LAKE AVE FORT WAYNE, IN 46805
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-24-2012
- Last Update Date
- 03-24-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Mental Illness
- Taxonomy Code
- 320800000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2026190
- Facility Type
- Other - INPATIENT RESIDENTIAL PSY
- Certificate Effective Date
- June 27, 2023
- Certificate Expiration Date
- June 26, 2025
- Laboratory Director
- LISA SPEARS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Crossroad Child And Family Services, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 8 | 9 | 9 | 4 | 0 | 6 | 7 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 16 | 9 | 18 | 4 | 0 | 6 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 6 + 9 + 1 + 8 + 4 + 0 + 6 + 1 + 4 + 24 = 72 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 72 = 8 | 8 | ||||||||
The NPI number 1689940678 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 18 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1992935142 | MR. STEWART GREGORY TIDWELL MA, LMHC Individual | Counselor (Mental Health) | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1467684936 | MRS. BARBARA A SCHULTZ MSW, LCSW Individual | Social Worker (Clinical) | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1679863880 | MRS. SHIRLEY ANN RYAN MS, LMHC, LMFTA Individual | Marriage & Family Therapist | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1336574656 | MARISSA K FRESON MSED, LMFTA Individual | Counselor (Mental Health) | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1770970337 | CROSSROAD CHILD AND FAMILY SERVICES Organization | Psychiatric Residential Treatment Facility | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1033599014 | CROSSROAD CHILD AND FAMILY SERVICES Organization | Community Based Residential Treatment Facility, Mental Illness | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1770064214 | NATALIE M COOK Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1487135869 | JACKIE DEAN VANNATTA JR. Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1912485459 | GERALD DEAN MCCALEB Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1023596665 | DAVID M GOETZ Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1497236442 | KATRINA LOUISE IMBER LSW Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 715-0410 |
| 1962984260 | JON ROBERT MOSEBY Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1962985424 | MATTHEW BROOKS FLINN Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1063996551 | SARAH NOREEN YORK Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1841774346 | CANDIS LEA LUCHNENKO Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1215491519 | JEFF NEWMAN Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 715-7995 |
| 1861956161 | PATRICIA CAROL WARD Individual | Case Manager/Care Coordinator | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
| 1275614109 | CROSSROAD - FORT WAYNE CHILDRENS HOME Organization | Clinic/Center (Adolescent and Children Mental Health) | 2525 LAKE AVE FORT WAYNE, IN 46805 (260) 484-4153 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689940678, enumerated in the NPI registry as an "organization" on March 24, 2012
The provider is located at 2525 Lake Ave Fort Wayne, In 46805 and the phone number is (260) 484-4153
This medical organization specializes in Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X
The provider's CLIA number is 15D2026190 for a "other - inpatient residential psy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on March 24, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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