SOUTHAVEN
NPI 1063188035
Assisted Living Facility in Kennett, MO
About Southaven NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHAVEN (NPI 1063188035) is a healthcare organization registered as an assisted living facility in Kennett, Missouri and active in the NPI registry since August 2021. The organization holds 2 active CLIA laboratory certificates and lists Scott Cole, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA 2
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 26D2117763
Crosstree Healthcare, LLC (d/B/A/ Southhaven) · Kennett, MOCertificate of Waiver 26D2117767
Crosstree Healthcare, LLC (dba The Haven) · Kennett, MOFrequently 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 Crosstree Healthcare LLC's NPI number?
The NPI number for Crosstree Healthcare LLC is 1063188035. It was assigned to this organization in the NPPES registry on August 19, 2021. The provider is doing business as Southaven.
Where is Crosstree Healthcare LLC located?
Crosstree Healthcare LLC is located at 612 South Byp, Kennett, MO 63857. The listed phone number is (573) 217-8669.
What is Crosstree Healthcare LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Crosstree Healthcare LLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Crosstree Healthcare LLC was last updated on October 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Southaven · NPI 1063188035
Assisted Living Facility organization in Kennett, Missouri. Organization record, active in the CMS NPPES registry since August 19, 2021.
## Identity
- **NPI:** 1063188035 (Entity type: Organization)
- **Enumerated:** August 19, 2021
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Legal business name:** Crosstree Healthcare Llc
- **Organization subpart:** No
- **Authorized official:** Scott Cole, OWNER
## Practice location
- **Address:** 612 SOUTH BYP, Kennett, MO 63857-3240
- **Phone:** (573) 217-8669
## Record status
- **NPPES last updated:** October 25, 2021
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063188035) · Data from the CMS NPPES public registry.