Healthcare Provider Details

I. General information

NPI: 1912061508
Provider Name (Legal Business Name): CROSSROADS MISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 S ARIZONA AVE
YUMA AZ
85364-3947
US

IV. Provider business mailing address

944 S ARIZONA AVE BLDG 200
YUMA AZ
85364-3947
US

V. Phone/Fax

Practice location:
  • Phone: 928-783-9362
  • Fax: 928-329-6020
Mailing address:
  • Phone: 928-783-9362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberBH-1142
License Number StateAZ

VIII. Authorized Official

Name: MYRA ELAINE GARLIT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M. ED., LIAC
Phone: 928-783-9362