NPIMap

Organization Active NPI

Crossroads Community, Inc.

  • Case Management Agency
  • Centreville, MD
National Provider Identifier
1609085976
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CROSSROADS COMMUNITY, INC.
Practice address
120 Banjo LN
Centreville, MD 21617-1002
Phone
(410) 758-3050
Fax
(410) 758-1223
NPI assigned
May 22, 2007
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Ms. Holly R. Ireland
Title
Executive Director
Phone
(410) 924-4893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

120 Banjo LN
Centreville, MD 21617-1002

Mailing address

PO Box 718
Centreville, MD 21617-0718
Phone (410) 758-3050

Other identifiers 1

IdentifierTypeStateIssuer
987430500MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Community Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1609085976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 718",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216170718",
            "telephone_number": "410-758-3050",
            "fax_number": "410-758-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BANJO LN",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171002",
            "telephone_number": "410-758-3050",
            "fax_number": "410-758-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "IRELAND",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-924-4893",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987430500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.