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NPI Code Detail

MEDICARE: CROSSROADS TREATMENT CENTERS OF NORTH CAROLINA, P.C.

MEDICARE: CROSSROADS TREATMENT CENTERS OF NORTH CAROLINA, P.C.
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
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QM2800XMethadone Clinic
4261QP2300XPrimary Care Clinic/Center
5261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
6261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1619695434
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROSSROADS TREATMENT CENTERS OF NORTH CAROLINA, P.C.
Provider Business Mailing Address
First Line : 200 E BROAD ST STE 300
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2891
Country : US
Telephone Number : 8-805-6989
Fax Number : 864-558-8511
Provider Business Practice Location Address
First Line : 2848 QUEEN CITY DR STE G
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-2739
Country : US
Telephone Number : 800-805-6989
Fax Number : 864-558-8511
Authorized Official
Title or Position : CEO
Name : RUPERT MCCORMAC
Credential : MD
Telephone Number : 800-805-6898
Provider Enumeration Date : 08/17/2022
Last Update Date : 08/17/2022

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