Healthcare Provider Details

I. General information

NPI: 1164746467
Provider Name (Legal Business Name): THE CROSS-OVER MINISTRY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2010
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 COWARDIN AVE
RICHMOND VA
23224-2020
US

IV. Provider business mailing address

8600 QUIOCCASIN RD
RICHMOND VA
23229-5514
US

V. Phone/Fax

Practice location:
  • Phone: 804-233-5016
  • Fax: 804-231-5723
Mailing address:
  • Phone: 804-655-2794
  • Fax: 804-422-2604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MISTI PROCIOUS
Title or Position: ADMINISTRATIVE COORDINATOR
Credential:
Phone: 804-655-2794