Healthcare Provider Details
I. General information
NPI: 1053266395
Provider Name (Legal Business Name): KROSSROADS INTEGRATIVE HEALTH AND RECOVERY SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
104 LEGION DR
LAS VEGAS NM
87701-4804
US
IV. Provider business mailing address
400 GOLD AVE SW STE 1300
ALBUQUERQUE NM
87102-3274
US
V. Phone/Fax
- Phone: 505-570-2526
- Fax:
- Phone: 505-715-4610
- Fax: 505-715-4620
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHLEEN
SCHWEDA-WEBB
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CEO
Phone: 505-238-2814