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NPI Code Detail

MEDICARE: CROSSROADS COMMUNITY SUPPORTED HEALTHCARE

MEDICARE: CROSSROADS COMMUNITY SUPPORTED HEALTHCARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1265884969
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSROADS COMMUNITY SUPPORTED HEALTHCARE
Provider Business Mailing Address
First Line : 1320 SOUTH SOLANO DRIVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-5672
Country : US
Telephone Number : 575-312-6569
Fax Number : 575-502-5013
Provider Business Practice Location Address
First Line : 1320 S SOLANO DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-3781
Country : US
Telephone Number : 575-312-6569
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. RYAN MICHAEL BEMIS
Credential : DOM, LAC
Telephone Number : 575-312-6569
Provider Enumeration Date : 07/06/2016
Last Update Date : 03/01/2017

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Directions to “CROSSROADS COMMUNITY SUPPORTED HEALTHCARE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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