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CROSSROAD CHILD AND FAMILY SERVICES
NPI 1033599014
Community Based Residential Treatment Facility, Mental Illness in Fort Wayne, IN

Active since June 04, 2015CLIA 15D2026190 · Waiver
2525 LAKE AVE, FORT WAYNE, IN 46805(260) 484-4153 Get Directions Write a Review

NPPES record last updated: June 4, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Crossroad Child And Family Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CROSSROAD CHILD AND FAMILY SERVICES (NPI 1033599014) is a healthcare organization registered as a community based residential treatment facility, mental illness in Fort Wayne, Indiana and active in the NPI registry since June 2015. The organization holds a CLIA Waiver certificate valid through June 26, 2027 and lists Ashlee Rager, Therapist, as its authorized official.

NPPES Registry Identity

NPI1033599014
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameCROSSROAD CHILD AND FAMILY SERVICES
Location Address2525 LAKE AVEFort Wayne, IN 46805-5407
Mailing Address2525 Lake AvenueFort Wayne, IN 46805
Phone(260) 484-4153
Organization SubpartNo
Authorized OfficialAshlee RagerTherapist · (260) 484-4153
Enumeration DateJune 4, 2015
✔ NPI 1033599014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
License✔ Licensed in IN · 35001873A
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
2525 LAKE AVE, Fort Wayne, IN 46805
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2026190

Crossroad Child And Family Services · Fort Wayne, IN
Active · expires Jun 26, 2027
CLIA Number15D2026190
Laboratory TypeLicensed Residential Faci
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorDarlene Evans
Laboratory Phone(260) 484-4153
Laboratory LocationCrossroad Child And Family Services1825 Beacon Street, Fort Wayne, IN 46805
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID M GOETZ
Case Manager/Care Coordinator
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 484-4153
SARAH NOREEN YORK
Case Manager/Care Coordinator
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 484-4153
JEFF NEWMAN
Case Manager/Care Coordinator
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 715-7995
CROSSROAD - FORT WAYNE CHILDRENS HOME
Clinic/Center (Adolescent and Children Mental Health)
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 484-4153
MARISSA K FRESON MSED, LMFTA
Counselor (Mental Health)
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 484-4153
MRS. BARBARA A SCHULTZ MSW, LCSW
Social Worker (Clinical)
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 484-4153
JACKIE DEAN VANNATTA JR.
Case Manager/Care Coordinator
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 484-4153
KATRINA LOUISE IMBER LSW
Case Manager/Care Coordinator
2525 LAKE AVE
FORT WAYNE, IN 46805
Allen County (260) 715-0410

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crossroad Child And Family Services's NPI number?

The NPI number for Crossroad Child And Family Services is 1033599014. It was assigned to this organization in the NPPES registry on June 4, 2015.

Where is Crossroad Child And Family Services located?

Crossroad Child And Family Services is located at 2525 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 484-4153.

What is Crossroad Child And Family Services's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Does Crossroad Child And Family Services hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2026190) is associated with this NPI, valid through June 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Crossroad Child And Family Services was last updated on June 4, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.