Healthcare Provider Details

I. General information

NPI: 1528278652
Provider Name (Legal Business Name): CROSS ROADS II DBA NEW DIRECTIONS OUTPATIENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 W SHARP AVE SUITE B
SPOKANE WA
99201-2460
US

IV. Provider business mailing address

539 W SHARP AVE SUITE B
SPOKANE WA
99201-2460
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-0304
  • Fax: 509-462-0530
Mailing address:
  • Phone: 509-838-0304
  • Fax: 509-462-0530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number32064700
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number32064700
License Number StateWA

VIII. Authorized Official

Name: MS. FLORENCE JOHNSON ARNETT
Title or Position: EXECUTIVE DIRECTOR
Credential: B.S., CDP, MRT
Phone: 509-838-0304