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General NPI Number Information
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NPI Number | 1740600410
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Entity Type | Organization
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Legal Business Name | CROSSROADS CENTER FOR RECOVERY
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 1001 MULHOLLAND ST
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City | BAY CITY
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State | MI
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Zip | 48708-7646
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Country | US
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Telephone | 989-391-9900
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Fax | 989-497-1530
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Provider Business Mailing Address
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Address Line | 1001 MULHOLLAND ST
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City | BAY CITY
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State | MI
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Zip | 48708-7646
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Country | US
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Telephone | 989-391-9900
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Fax | 989-497-1530
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KATHY PALMER
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Credential | LMSW
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Telephone | 989-391-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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