Crossroads of New Jersey Management, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CROSSROADS OF NEW JERSEY MANAGEMENT, LLC

Doing business as

Crossroads Treatment Center of Pennsauken

Practice address

5261 Marlton Pike Ste B
Pennsauken, NJ 08109-4701

Phone

(800) 805-6989

Fax

(864) 558-8511

NPI assigned

Aug 6, 2021

Last updated

Apr 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rupert James McCormac, MDNPI 1669486239

Title

Ceo

Phone

(800) 805-6989

Specialties & licenses 6

Addresses

Other names 1

• Crossroads Treatment Center of Pennsauken Doing business as

Tax ID family

Crossroads of New Jersey3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Crossroads of New Jersey Management, LLC

  dba Crossroads Treatment Center of Williamstown

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Williamstown, NJ
  • NPI 1477227064
  NPD tax ID
• Crossroads Treatment Center of Woodbury Heights

  • Methadone Clinic
  • Woodbury Heights, NJ
  • NPI 1851020986
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rupert James McCormac IV, M.D.

  • Psychiatry Physician
  • Greer, SC
  • NPI 1669486239
  Authorized official Same address or phone

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712448000000",
    "number": "1487328076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749057",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749057",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 MARLTON PIKE STE B",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081094701",
            "telephone_number": "800-805-6989",
            "fax_number": "864-558-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS OF NEW JERSEY MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-06",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A",
        "authorized_official_last_name": "MCCORMAC",
        "authorized_official_first_name": "RUPERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-805-6989",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Treatment Center of Pennsauken",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Treatment Center of Pennsauken",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kathleen Cummings, APN
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• Substance Use Disorder Rehabilitation Clinic/Center in Pennsauken, NJ
• Providers in Pennsauken, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; 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.