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CROSSROAD - FORT WAYNE CHILDRENS HOME
NPI 1275614109
Clinic/Center - Adolescent and Children Mental Health in Fort Wayne, IN

Active since October 18, 2006
2525 LAKE AVE, FORT WAYNE, IN 46805(260) 484-4153 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Crossroad - Fort Wayne Childrens Home NPPES

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

CROSSROAD - FORT WAYNE CHILDRENS HOME (NPI 1275614109) is a healthcare organization registered as an adolescent and children mental health in Fort Wayne, Indiana and active in the NPI registry since October 2006. The organization lists Jc Dollar, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1275614109
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameCROSSROAD - FORT WAYNE CHILDRENS HOME
Location Address2525 LAKE AVEFort Wayne, IN 46805-5407
Mailing Address2525 Lake AveFort Wayne, IN 46805-5407 · (260) 484-4153
Phone(260) 484-4153
Organization SubpartNo
Authorized OfficialJc DollarCeo/president · (260) 484-4153
Enumeration DateOctober 18, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1275614109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
License✔ Licensed in IN · 7342602900837
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
2525 LAKE AVE, Fort Wayne, IN 46805
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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
CROSSROAD CHILD AND FAMILY SERVICES
Community Based Residential Treatment Facility, Mental Illness
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
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 - Fort Wayne Childrens Home's NPI number?

The NPI number for Crossroad - Fort Wayne Childrens Home is 1275614109. It was assigned to this organization in the NPPES registry on October 18, 2006.

Where is Crossroad - Fort Wayne Childrens Home located?

Crossroad - Fort Wayne Childrens Home is located at 2525 Lake Ave, Fort Wayne, IN 46805. The listed phone number is (260) 484-4153.

What is Crossroad - Fort Wayne Childrens Home's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Crossroad - Fort Wayne Childrens Home was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.