| Crossroads Family Care | |
|
1115 Highway 259 South Henderson TX 75654 | |
| (903) 822-3076 | |
| (903) 822-3079 |
| Full Name | Crossroads Family Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1115 Highway 259 South, Henderson, Texas |
| Authorized Official Name and Position | Kenneth A White (CEO) |
| Authorized Official Contact | 9038223076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Family Care Po Box 489 Mount Enterprise TX 75681-0489 Ph: (903) 822-3076 | Crossroads Family Care 1115 Highway 259 South Henderson TX 75654 Ph: (903) 822-3076 |
| NPI Number | 1649412354 |
|---|---|
| Provider Enumeration Date | 03/26/2009 |
| Last Update Date | 10/14/2021 |
| Medicare PECOS PAC ID | 2860303922 |
|---|---|
| Medicare Enrollment ID | O20090916000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649412354 | NPI | - | NPPES |
| 203375502 | Medicaid | TX | |
| 203375501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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