DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: CROSSROADS TREATMENT CENTER OF PETERSBURG, PC

MEDICARE: CROSSROADS TREATMENT CENTER OF PETERSBURG, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QM1300XMulti-Specialty Clinic/Center
4261QM2800XMethadone Clinic
5261QP2300XPrimary Care Clinic/Center
6261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1699218669
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSROADS TREATMENT CENTER OF PETERSBURG, PC
Provider Business Mailing Address
First Line : PO BOX 749057
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9057
Country : US
Telephone Number : 800-805-6989
Fax Number : 864-558-8511
Provider Business Practice Location Address
First Line : 10543 S CRATER RD
Second Line :
City : SOUTH PRINCE GEORGE
State : VA
Zip : 23805-7333
Country : US
Telephone Number : 800-805-6989
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. RUPERT J. MCCORMAC IV
Credential : MD
Telephone Number : 800-805-6989
Provider Enumeration Date : 11/23/2016
Last Update Date : 09/03/2024

Similar Medicare Providers

1972940039 — MISS TRACY LENORA COLEMAN CEO
Practice Location Address:
10537 S CRATER RD
SOUTH PRINCE GEORGE, VA
23805-7333
Practice Phone: 757-637-8764
Practice Fax: 804-895-6884
1407387335 — CANDACE RABURN
Practice Location Address:
10543 S CRATER RD
SOUTH PRINCE GEORGE, VA
23805-7333
Practice Phone: 800-805-6989
Practice Fax:
1801327721 — SHANNON OCONNOR
Practice Location Address:
10543 S CRATER RD
SOUTH PRINCE GEORGE, VA
23805-7333
Practice Phone: 800-805-6989
Practice Fax:
1427589340 — OTELIA BRYANT
Practice Location Address:
10543 S CRATER RD
SOUTH PRINCE GEORGE, VA
23805-7333
Practice Phone: 800-805-6989
Practice Fax:
1518494582 — GABRIELLE SINCLAIR
Practice Location Address:
10543 S CRATER RD
SOUTH PRINCE GEORGE, VA
23805-7333
Practice Phone: 804-431-5585
Practice Fax:
1508393588 — TRACEY SEEGE
Practice Location Address:
10543 S CRATER RD
SOUTH PRINCE GEORGE, VA
23805-7333
Practice Phone: 804-431-5585
Practice Fax:

Directions to “CROSSROADS TREATMENT CENTER OF PETERSBURG, PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.