Healthcare Provider Details

I. General information

NPI: 1740877489
Provider Name (Legal Business Name): CROSSROADS TURNING POINTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 BONFORTE BLVD
PUEBLO CO
81001-1602
US

IV. Provider business mailing address

4 MONTEBELLO RD
PUEBLO CO
81001-1237
US

V. Phone/Fax

Practice location:
  • Phone: 719-404-1992
  • Fax: 719-404-1996
Mailing address:
  • Phone: 719-546-6667
  • Fax: 719-546-8273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: BANAFSHE' KING
Title or Position: CREDENTIALING & ENROLLMENT SPEC
Credential:
Phone: 719-419-7959