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NPI Code Detail

MEDICARE: CROSSROAD BEHAVIORAL HEALTHCARE, LLC

MEDICARE: CROSSROAD BEHAVIORAL HEALTHCARE, LLC
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1417322793
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSROAD BEHAVIORAL HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 3436 MAGAZINE ST
Second Line : SUITE 454
City : NEW ORLEANS
State : LA
Zip : 70115-2413
Country : US
Telephone Number : 813-616-9333
Fax Number : 800-886-9502
Provider Business Practice Location Address
First Line : 3436 MAGAZINE ST
Second Line : SUITE 454
City : NEW ORLEANS
State : LA
Zip : 70115-2413
Country : US
Telephone Number : 813-616-9333
Fax Number : 800-886-9502
Authorized Official
Title or Position : OWNER
Name : OLIVIA ANDERSON
Credential :
Telephone Number : 813-616-9333
Provider Enumeration Date : 12/11/2015
Last Update Date : 12/11/2015

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Directions to “CROSSROAD BEHAVIORAL HEALTHCARE, LLC ” Practice Location

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