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General NPI Number Information
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NPI Number | 1770335952
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Entity Type | Organization
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Legal Business Name | CROSSROADS RECOVERY CENTER
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 536 W LINE ST
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City | BISHOP
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State | CA
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Zip | 93514-3313
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Country | US
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Telephone | 760-937-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 536 W LINE ST UNIT A
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City | BISHOP
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State | CA
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Zip | 93514-3313
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Country | US
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Telephone | 760-937-4270
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ARLENE BROWN
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Credential |
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Telephone | 760-258-5705
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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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