NPIMap

Organization Active NPI

Crossroads Extension

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1184102709
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-5467 Issued in AZ
Legal business name
CROSSROADS EXTENSION
Practice address
244 N Extension Rd
Mesa, AZ 85201-6300
Phone
(602) 263-5242
Fax
(602) 595-4434
NPI assigned
Aug 6, 2018
Organization subpart
Yes
Parent organization
CROSSROADS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chris Riley
Title
Executive Director
Phone
(602) 263-5242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-5467 AZ Primary

Addresses

Primary practice location

244 N Extension Rd
Mesa, AZ 85201-6300

Mailing address

2002 E Osborn Rd
Phoenix, AZ 85016-7236
Phone (602) 263-5242

Other identifiers 1

IdentifierTypeStateIssuer
397764MedicaidAZ

Other names 1

  • Extension SABG Other name

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Scottsdale28 organizations share this tax ID, including this one
Part of
Crossroads Scottsdale

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1184102709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 E OSBORN RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167236",
            "telephone_number": "602-263-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N EXTENSION RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016300",
            "telephone_number": "602-263-5242",
            "fax_number": "602-595-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS EXTENSION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROSSROADS, INC.",
        "enumeration_date": "2018-08-06",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-263-5242"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-5467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "397764",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Extension SABG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.