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FQHCLA452 CROSSROADS HEALTH (Active)
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Main Details
Name
CROSSROADS HEALTH
Subdivision Name
Crossroads Health Mentor Avenue
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-036624
340B ID
FQHCLA452
Grant Number
LALCS49106
Additional Details
Current Program Status
Active
Registration Date
7/6/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/8/2023
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Crossroads Health
Michael Matoney, CEO
(216) 548-3634
Primary Contact
Crossroads Health
Shannon Lee Seifreit, Director of Quality Improvement
(440) 856-0182
Addresses
Street Address
9220 Mentor Ave
Mentor, OH 44060-6412
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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