Healthcare Provider Details

I. General information

NPI: 1174450902
Provider Name (Legal Business Name): THE CROSSROADS ABA CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W PARKWAY DR
EGG HARBOR TOWNSHIP NJ
08234-5107
US

IV. Provider business mailing address

205 W PARKWAY DR
EGG HARBOR TOWNSHIP NJ
08234-5105
US

V. Phone/Fax

Practice location:
  • Phone: 609-645-2146
  • Fax: 609-645-9467
Mailing address:
  • Phone: 609-645-2146
  • Fax: 609-645-9467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ALEX KUSHNIR
Title or Position: MANAGING MEMBER, CFO
Credential:
Phone: 609-645-2500