Crossroad - Fort Wayne Childrens Home
NPI #1275614109 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1275614109
- Entity Type
- Organization
- Organization Name
- Crossroad - Fort Wayne Childrens Home
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- Oct 18, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2525 LAKE AVE
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46805-5407
- Phone
- (260) 484-4153
Authorized Official
- Name
- MR. JC DOLLAR
- Title
- CEO/PRESIDENT
- Phone
- (260) 484-4153
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
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