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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Oak Grove, MO · Community/Behavioral Health Agency in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.