CROSSROADS TREATMENT CENTER OF WEST MEMPHIS, PC (NPI# 1043715329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043715329 |
| Entity Type | Organization |
| Organization Name | CROSSROADS TREATMENT CENTER OF WEST MEMPHIS, PC |
| Practice Address |
103 S Avalon St West Memphis AR 72301 |
| Mailing Address |
55 Beattie Pl Ste 810 Greenville SC 29601-2191 |
| Practice Telephone | 8703944307 |
| Practice Fax Number | 8703949936 |
| Mailing Telephone | 8645273145 |
| Mailing Fax Number | 8649900653 |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | RUPERT JAMES MCCORMAC (PRESIDENT) |
| Authorized Official Telephone | 8645273145 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
AR | Ambulatory Health Care Facilities | |
| N | 251S00000X | Community/Behavioral Health | AR | Agencies | |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
103 S AVALON ST |
| City | WEST MEMPHIS |
| State | AR |
| Zip Code | 72301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417454927 | Richard Wheeler | Counselor | 103 S Avalon St, West Memphis, AR 72301-4165 | 2018-04-11 |
| 1114424645 | Heather Sharpe | Registered Nurse | 103 S Avalon St, West Memphis, AR 72301-4165 | 2018-04-11 |
| 1184121618 | Charissa Morris | Registered Nurse | 103 S Avalon St, West Memphis, AR 72301-4165 | 2018-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755497 | Shannon Mcelroy | Pharmacist | 300 I-40 Service Rd, West Memphis, AR 72301 | 2020-06-23 |
| 1891319745 | Heather Nichole Fesperman | Nurse Practitioner | 420 W Cooper Ave, West Memphis, AR 72301 | 2020-06-05 |
| 1174161475 | Mary Williams | Pharmacist | 300 I-40 Service Road, West Memphis, AR 72301 | 2019-12-17 |
| 1336787035 | Yolanda Monique Fulton | Assisted Living Facility | 711 Purduve Ave, West Memphis, AR 72301 | 2019-12-13 |
| 1255813317 | Urgent Care Travel, Inc | Clinic/Center | 3400 Service Loop 2, West Memphis, AR 72301 | 2018-09-05 |
| 1841770302 | Cuffie Healthcare LLC | Home Health | 403 Ingram Blvd, West Memphis, AR 72301 | 2018-08-15 |
| 1467940312 | Mark Aaron Whitlock | Dentist | 110 Dover Rd, West Memphis, AR 72301 | 2018-04-26 |
| 1114445202 | Deborah Thompson Ferguson | Dentist | 200 S Rhodes St Ste B, West Memphis, AR 72301 | 2017-09-08 |
| 1154745487 | Erin Camille Greer | Specialist/Technologist | 610 N. Missouri Street, Suite 1, West Memphis, AR 72301 | 2014-02-06 |
| 1760721369 | Amber Tackett | Pharmacist | 300 W Service Road, West Memphis, AR 72301 | 2013-02-04 |
| Find all providers in zip 72301 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306484860 | Eaglecrest Recovery LLC | Clinic/Center | 1106 Sw 2nd St, Bentonville, AR 72712-5026 | 2019-12-16 |
| 1407407570 | Serenity Park Recovery Clinic | Clinic/Center | 2711 W Roosevelt Rd, Little Rock, AR 72204-5668 | 2019-09-20 |
| 1447723143 | Sozo Recovery Centers Inc | Clinic/Center | 243 Nathan Ter, Jessieville, AR 71949-9289 | 2019-01-04 |
| 1346642634 | Addiction & Mental Health Services, LLC | Clinic/Center | 11215 Hermitage Rd Ste 204, Little Rock, AR 72211-3864 | 2014-09-18 |
| 1942403696 | Gateway House Inc | Clinic/Center | 3900 Armour Avenue, Fort Smith, AR 72904-4317 | 2007-06-08 |
| 1285273219 | True Self Recovery LLC | Clinic/Center | 1104 N 2nd St, Rogers, AR 72756-2834 | 2019-12-20 |
| 1902443229 | Quapaw House | Clinic/Center | 615 W Grand Ave, Hot Springs, AR 71901-3927 | 2019-12-05 |
| 1255977054 | University of Arkansas for Medical Sciences | Clinic/Center | 4224 Shuffield Drive, Little Rock, AR 72205-7101 | 2019-11-27 |
| 1447780952 | Arc Rehabilitation Center Pa | Clinic/Center | 1 Lile Ct Ste 103, Little Rock, AR 72205-6239 | 2017-06-16 |
| 1013461987 | Jefferson Comprehensive Counseling Associates | Clinic/Center | 2304 W 29th Ave, Pine Bluff, AR 71603-5005 | 2016-08-09 |
| Find all providers with the same taxonomy | ||||
| City | WEST MEMPHIS |
| Zip Code | 72301 |
Please comment or provide details below to improve the information on CROSSROADS TREATMENT CENTER OF WEST MEMPHIS, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.