CROSSROADS TREATMENT CENTER OF CHARLESTON, PC (NPI# 1114460375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114460375 |
| Entity Type | Organization |
| Organization Name | CROSSROADS TREATMENT CENTER OF CHARLESTON, PC |
| Practice Address |
2470 Mall Dr Unit C North Charleston SC 29406-6514 |
| Practice Telephone | 8432074721 |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2019-08-03 |
| Authorized Official Name | DR. RUPERT J. MCCORMAC IV (CEO) |
| Authorized Official Telephone | 8287192753 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
2470 MALL DR UNIT C |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29406-6514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992323174 | Michael Terry Chester | Counselor | 2470 Mall Dr, North Charleston, SC 29406-6514 | 2020-07-14 |
| 1669038030 | Kelston J'kay Ferrell | Pharmacy Technician | 2470 Mall Dr, North Charleston, SC 29406-6514 | 2019-05-11 |
| 1124584388 | Emily Grimes | Counselor | 2470 Mall Dr, North Charleston, SC 29406-6514 | 2019-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
| 1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
| 1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
| 1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
| 1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
| Find all providers in zip 29406 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437383403 | Center for Behavioral Health South Carolina, Inc | Clinic/Center | 2301 Cosgrove Ave Ste F, North Charleston, SC 29405-7663 | 2009-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356893416 | Solutions Recovery Center, Inc. | Clinic/Center | 520 Lowndes Hill Rd, Greenville, SC 29607-1405 | 2016-10-25 |
| 1922487610 | Cornerstone Project Sc, LLC | Clinic/Center | 1919 Hampton St, Columbia, SC 29201-3535 | 2015-05-27 |
| 1912345893 | Shoreline Behavioral Health Service | Clinic/Center | 626 Tyson Dr, Pawleys Island, SC 29585-6925 | 2013-06-12 |
| 1801131420 | Recoverylife, LLC | Clinic/Center | 2246 Sumter St, Columbia, SC 29201-1932 | 2012-12-07 |
| 1780934976 | Pavillon Greenville Outpatient Services | Clinic/Center | 101 Pelham Commons Blvd, Greenville, SC 29615-4974 | 2012-09-14 |
| 1376691022 | Saluda County Alcohol & Drug Abuse Comm | Clinic/Center | 204 N Ramage St, Saluda, SC 29138-1359 | 2007-01-08 |
| 1487665055 | Fairfield Behavioral Health Services | Clinic/Center | 178 Us Highway 321 Bypass N., Winnsboro, SC 29180 | 2006-08-10 |
| 1053340273 | Greenwood-edgefield-mccormick-abbeville Commission On Alcohol and Drug | Clinic/Center | 1420 Spring St, Greenwood, SC 29646-4057 | 2006-07-01 |
| 1972532075 | Laurens County Commission On Alcohol and Drug Abuse | Clinic/Center | 219 Human Services Road, Clinton, SC 29325 | 2006-07-01 |
| 1972574101 | The Ernest E. Kennedy Center | Clinic/Center | 306 Airport Dr, Moncks Corner, SC 29461-2629 | 2006-01-27 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29406 |
Please comment or provide details below to improve the information on CROSSROADS TREATMENT CENTER OF CHARLESTON, 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.