Basic Information
| Provider Information | |||||||||
| NPI: | 1568820207 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CROSS CITY OPERATIONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 410 MONMOUTH AVE APT 201 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087013747 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 583 NE HIGHWAY 351 | ||||||||
| Address2: | |||||||||
| City: | CROSS CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326283108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524982005 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2016 | ||||||||
| LastUpdateDate: | 03/09/2016 | ||||||||
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| AuthorizedOfficialLastName: | STEINMETZ | ||||||||
| AuthorizedOfficialFirstName: | HENRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7328135000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.