Healthcare Provider Details

I. General information

NPI: 1225194004
Provider Name (Legal Business Name): CROSS ROADS RECONCILIATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PINEY FOREST RD SUITE 108
DANVILLE VA
24540-2867
US

IV. Provider business mailing address

625 PINEY FOREST RD SUITE 108
DANVILLE VA
24540-2867
US

V. Phone/Fax

Practice location:
  • Phone: 434-791-2767
  • Fax: 434-791-4944
Mailing address:
  • Phone: 434-791-2767
  • Fax: 434-791-4944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberCU74420
License Number StateFL

VIII. Authorized Official

Name: DR. REGINA DAVIS CURTIS
Title or Position: CLINICAL SUPERVISOR
Credential: D. MIN.
Phone: 434-791-2767