MEDICARE: CRISIS RECOVERY AND PROGRESSIVE PATH SERVICES INC.

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1740015692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRISIS RECOVERY AND PROGRESSIVE PATH SERVICES INC.

Provider Business Mailing Address
First Line	:	7990 BAYMEADOWS RD E UNIT 1001
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2977
Country	:	US
Telephone Number	:	904-250-7363
Fax Number	:	904-374-2121

Provider Business Practice Location Address
First Line	:	7990 BAYMEADOWS RD E UNIT 1001
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-2977
Country	:	US
Telephone Number	:	904-250-7363
Fax Number	:	904-374-2121

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ERICA KAY EVANS
Credential	:
Telephone Number	:	904-250-7363

Provider Enumeration Date	:	09/02/2024
Last Update Date	:	09/02/2024

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