CROSSROADS TREATMENT CENTER OF FORT WORTH, PLLC (NPI# 1245765585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245765585 |
| Entity Type | Organization |
| Organization Name | CROSSROADS TREATMENT CENTER OF FORT WORTH, PLLC |
| Practice Address |
6733 Camp Bowie Blvd Fort Worth TX 76116-7112 |
| Practice Telephone | 8173869180 |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2020-01-15 |
| Authorized Official Name | MEGAN THOMAS (OPERATIONS SPECIALIST FOR STRATEGIC) |
| Authorized Official Telephone | 8287192753 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Street Address |
6733 CAMP BOWIE BLVD |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76116-7112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091480 | Elizabeth Capps | Licensed Vocational Nurse | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2020-10-23 |
| 1194363796 | Dominique Stevenson | Licensed Vocational Nurse | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2019-12-13 |
| 1639715063 | Ashley Anderson | Licensed Vocational Nurse | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2019-11-20 |
| 1629628755 | Angela Kaye Aurell | Counselor | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2019-09-20 |
| 1851956015 | Jenishia Ford | Licensed Vocational Nurse | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2019-05-03 |
| 1124515168 | Natalie Townson | Licensed Vocational Nurse | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2018-04-16 |
| 1871097634 | Cletis Hubbard | Counselor | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2018-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908980 | William Michael Marshall | Pharmacist | 8600 Camp Bowie Blvd, Forth Worth, TX 76116 | 2020-10-02 |
| 1558843599 | Donnisha Bunting | In Home Supportive Care | 2901 Broadmoor, 1115, Fort Worth, TX 76116 | 2018-09-06 |
| 1588156756 | Bilal Master | Student in an Organized Health Care Education/Training Program | 3309 Riveroad Court, 2515, Ft Worth, TX 76116 | 2018-06-04 |
| 1245769728 | Randall R Williams | Physical Therapist | 6913 Camp Bowie Blvd Suite 141, Fort Worth, TX 76116 | 2017-06-08 |
| 1023543048 | 5th Avenue Grooming Lounge | Prosthetic/Orthotic Supplier | 1201 N Watson Rd., Suite 283, Arlington, TX 76116 | 2017-04-27 |
| 1831647734 | Frisco Neuro Collaborations, Pllc | Physician Assistant | 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 | 2016-09-20 |
| 1104288372 | Brown Mobile Dental Pa | Dentist | 8008 Camp Bowie W Blvd, Ste 101, Fort Worth, TX 76116 | 2016-03-25 |
| 1639553431 | Bartholomew A Akubukwe | Pharmacist | 6700 Westfree Way, Fortworth, TX 76116 | 2015-07-13 |
| 1952718868 | Brown Mobile Dental | Dentist | 8008 Camp Bowie Suite 101, Fort Worth, TX 76116 | 2014-07-14 |
| 1275949018 | Emily Sue Danner | Dentist | 6726 Camp Bowie Blvd., Fort Worth, TX 76116 | 2014-07-01 |
| Find all providers in zip 76116 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770781106 | Medmark Treatment Centers of Texas Inc | Clinic/Center | 5201 Mccart Ave, Suite H, Fort Worth, TX 76115-3711 | 2007-07-06 |
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| 1730652751 | North West Frontier Recovery Pllc | Clinic/Center | 225 Metro Dr Ste 100, Terrell, TX 75160-9103 | 2019-01-03 |
| 1811417397 | Mars S.a. LLC. | Clinic/Center | 437 Mccarty Rd Ste 600, San Antonio, TX 78216-4445 | 2017-06-26 |
| 1689194151 | Medication Assisted Recovery Services Mars, LLC | Clinic/Center | 1101 Arrow Point Dr Ste 214, Cedar Park, TX 78613-7739 | 2017-06-26 |
| 1083150569 | Mcet-longview | Clinic/Center | 505 North Sixth Street, Longview, TX 75602 | 2017-01-09 |
| 1902263478 | Eldorado Texas Community Service Center | Clinic/Center | 5510 N Cage Blvd Ste P, Pharr, TX 78577-1813 | 2016-01-28 |
| 1891169215 | Medmark Treatment Centers of Texas,inc | Clinic/Center | 5004 Alameda Ave, El Paso, TX 79905-2804 | 2015-11-23 |
| 1598133472 | Inspired Hope Group LLC | Clinic/Center | 1228 W Scyene Rd Ste 230, Mesquite, TX 75149-3143 | 2015-09-09 |
| 1184036790 | Mcet-waskom Limited Liability Company | Clinic/Center | 670 Spur 156, Waskom, TX 75692-9129 | 2014-06-02 |
| 1821419201 | Lifes Second Chance Treatment Center Lakisha Henderson Nelson Sole Mbr | Clinic/Center | 2615 S Lancaster Rd, Dallas, TX 75216-3112 | 2014-01-02 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76116 |
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| 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.