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General NPI Number Information
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NPI Number | 1801922869
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Entity Type | Organization
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Legal Business Name | TAMPA CROSSROADS, INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 460 3RD ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-2908
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Country | US
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Telephone | 727-898-0088
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Fax |
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Provider Business Mailing Address
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Address Line | 5118 N NEBRASKA AVE
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City | TAMPA
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State | FL
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Zip | 33603-2363
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Country | US
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Telephone | 813-238-5210
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SARA ROMEO
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Credential |
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Telephone | 813-238-5210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | SR52AD371903
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License Number State | FL
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