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General NPI Number Information
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NPI Number | 1891009205
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Entity Type | Organization
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Legal Business Name | CROSS ROADS RECOVERY CENTER INC.
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 5552 S HAMPTON RD
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City | DALLAS
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State | TX
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Zip | 75232-2202
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Country | US
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Telephone | 214-339-3181
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Fax | 214-339-2885
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Provider Business Mailing Address
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Address Line | 5552 S HAMPTON RD
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City | DALLAS
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State | TX
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Zip | 75232-2202
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Country | US
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Telephone | 214-339-3181
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Fax | 214-339-2885
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH FRANCIS BAIAMONTE III
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Credential | LCDC
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Telephone | 214-339-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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