Crossroads of Pella

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1339 Issued in IA

Legal business name

CROSSROADS OF PELLA

Practice address

103 North 3Rd Street
Oskaloosa, IA 52577

Phone

(641) 676-4060

Fax

(641) 676-3721

NPI assigned

Sep 22, 2010

Organization subpart

Yes

Parent organization

CROSSROADS OF PELLAAs reported in NPPES

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

Authorized official

Name

Ms. Deborah Emily Kay, MS ACADC

Title

Clinical Director

Phone

(641) 780-1087

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Edge of Recovery Doing business as

Part of

Crossroads of Pella

Locations

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1972811198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 UNION STREET",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "50219",
            "telephone_number": "641-628-1212",
            "fax_number": "641-628-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 NORTH 3RD STREET",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "52577",
            "telephone_number": "641-676-4060",
            "fax_number": "641-676-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS OF PELLA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROSSROADS OF PELLA",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "KAY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "EMILY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "641-780-1087",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS ACADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": "1339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT AND JUVENILE LEVEL I SUBSTANCE ABUSE TREATMENT SERVICES",
            "identifier": "1339",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Edge of Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald Benjamin Collins Jr., M.D.
• Ryan Joseph Collins
• Michelle Erin Connell, DPT, ATC
• Country Life Health Care Inc
• Sean Crawford, DO
• Danny R Crow, CADC
• Crystal Properties Inc.
• Anne Cunningham
• Michelle Rene Curtis, MHC
• Jessica Daniel

• All providers in Oskaloosa, IA
• Community/Behavioral Health Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.