NPIMap

Organization Active NPI

Crossroads Wellness LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1992440242
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CROSSROADS WELLNESS LLC
Practice address
3302 Washington Blvd
Baltimore, MD 21227-1618
Phone
(410) 697-5502
Fax
(410) 457-9420
NPI assigned
May 2, 2022
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Ms. Megan Joy Devaughn
Title
Partner
Phone
(443) 484-6408

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Community/Behavioral Health Agency 251S00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3302 Washington Blvd
Baltimore, MD 21227-1618

Mailing address

17331 Bushland Rd
Parkton, MD 21120-9476
Phone (443) 484-6408

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Wellness LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4811 Leeds Ave
Ste E
Baltimore, MD 21227

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1992440242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17331 BUSHLAND RD",
            "city": "PARKTON",
            "state": "MD",
            "postal_code": "211209476",
            "telephone_number": "443-484-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 WASHINGTON BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271618",
            "telephone_number": "410-697-5502",
            "fax_number": "410-457-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "DEVAUGHN",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "443-484-6408",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.