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General NPI Number Information
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NPI Number | 1053738328
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Entity Type | Organization
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Legal Business Name | CROSSROADS COUNSELING MINISTRIES
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 163 CHURCHGROVE RD
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City | FRANKENMUTH
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State | MI
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Zip | 48734-1025
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Country | US
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Telephone | 989-652-9764
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 88 163 CHURCHGROVE RD
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City | FRANKENMUTH
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State | MI
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Zip | 48734-0088
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Country | US
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Telephone | 989-652-0764
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | JEREMY FRANK
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Credential | ACCOUNTANT
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Telephone | 989-652-6121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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