| Organization Name: | CROSSROADS SURGERY CENTER INC |
| NPI Number: | 1114057023 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL GEORGE RICHIE (OWNER) |
| Mailing Address: | 1575 20th St Nw Ste 203 Faribault |
| State: | MN US |
| Postal Code: | 550212930 |
| Phone Number: | 5073329900 |
| Fax Number: | 5073326800 |
| NPI Enumeration Date: | 03/07/2007 |
| NPI Last Update Date: | 05/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 8598271 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |