Crossroads Behavioral Services, LLC

Organization Active NPI Community/Behavioral Health Agency · Oak Grove, MO

NPI 1043580194 · NPPES record last updated May 14, 2012

Key facts

NPI
1043580194
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
CROSSROADS BEHAVIORAL SERVICES, LLC
Practice address
1611 Deer Run Rd.
Oak Grove, MO 64075
Phone
(816) 838-1808
NPI assigned
Jan 6, 2012
Organization subpart
No

Authorized official

Name
Jeremiah Thomas Hartley, MA
Title
Ceo
Phone
(816) 838-1808

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes
Early Intervention Provider Agency 252Y00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 120123210218441 MO

Addresses

Primary practice location

1611 Deer Run Rd.
Oak Grove, MO 64075

Mailing address

1611 Deer Run Rd
Oak Grove, MO 64075-5210
Phone (816) 838-1808

Other providers in Oak Grove, MO

All providers in Oak Grove, MO · Community/Behavioral Health Agency in Missouri

Sources for this page

Verify at the official NPI Registry.