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General NPI Number Information
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NPI Number | 1609871391
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Entity Type | Organization
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Legal Business Name | CROSS ROAD HEALTH MINISTRIES, INC.
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | MILE 187 GLENN HIGHWAY
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City | GLENNALLEN
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State | AK
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Zip | 99588-0589
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Country | US
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Telephone | 907-822-3203
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Fax | 907-822-5805
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Provider Business Mailing Address
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Address Line | PO BOX 5
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City | GLENNALLEN
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State | AK
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Zip | 99588-0589
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Country | US
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Telephone | 907-822-5686
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Fax | 907-822-5684
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Authorized Official
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Title or Position | CEO
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Name | STEVEN WILLIAM GALLAGHER
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Credential |
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Telephone | 907-822-5686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 10300
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License Number State | AK
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