CROSSROADS MIDTOWN (NPI# 1700309879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700309879 |
| Entity Type | Organization |
| Organization Name | CROSSROADS MIDTOWN |
| Practice Address |
3702 N 13th Ave Phoenix AZ 85013-3677 |
| Mailing Address |
1700 E Thomas Rd Phoenix AZ 85016-7605 |
| Practice Telephone | 6022668400 |
| Mailing Telephone | 6022635242 |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |
| Authorized Official Name | JOHN HOUSE (PROGRAM COORDINATOR) |
| Authorized Official Telephone | 6022668400 |
| Is Organization Subpart | Y |
| Parent Organization Name | CROSSROADS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 870925 | 05 |
| Street Address |
3702 N 13TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85013-3677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134557028 | Crossroads, Inc | Community Based Residential Treatment Facility, Mental Illness | 3702 N 13th Ave, Phoenix, AZ 85013-3677 | 2013-10-31 |
| 1255962270 | Crossroads, Inc | Clinic/Center | 3702 N 13th Ave, Phoenix, AZ 85013-3677 | 2020-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043833700 | Marco Antonio Valdez Espinoza | Student in an Organized Health Care Education/Training Program | 500 W. Thomas Road, Suite 900 A, Phoenix, AZ 85013 | 2020-05-28 |
| 1518588292 | Santiago Garcia Ortiz | Student in an Organized Health Care Education/Training Program | 350w Thomas Rd St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013 | 2020-05-04 |
| 1356811970 | Lynne Shaunte Coleman | Nurse Practitioner | 3633 N 3rd Ave 2019, Phoenix, AZ 85013 | 2018-11-26 |
| 1467949156 | Solterra 3rd Indian School Operations, LLC | Assisted Living Facility | 4000 N 3rd Avenue, Phoenix, AZ 85013 | 2018-04-18 |
| 1083018345 | Romelda Antonio | Nurse Practitioner | 222 W Thomas Rd Ste 212, Phoenix, AZ 85013 | 2014-10-15 |
| 1760890131 | Emmitt Michael Thompson | General Practice | 822 West Earll Drive, Phoenix, AZ 85013 | 2014-07-29 |
| 1902218480 | Sreeja Biswas Roy | Internal Medicine | 350 W Thomas Road, Phoenix, AZ 85013 | 2014-06-02 |
| 1417381120 | Osama Qasim Agha | Internal Medicine | 350 W. Thomas Road, Suite 900a, Phoenix, AZ 85013 | 2013-08-29 |
| 1245679604 | Oculist Exceptional Eyewear Pllc | Optometrist | 5043-b N 7th Ave, Phoenix, AZ 85013 | 2013-06-19 |
| 1760829352 | Gina Wilding | Nurse Practitioner | 500 W Thomas Rd Ste 720, Phoenix, AZ 85013 | 2013-05-23 |
| Find all providers in zip 85013 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726361 | Northstar Homecare LLC | Substance Abuse Rehabilitation Facility | 5239 S 33rd Dr, Phoenix, AZ 85041-7411 | 2020-07-01 |
| 1891312542 | Semper Fidelis Behavioral Health Care, LLC | Substance Abuse Rehabilitation Facility | 8020 N 17th Dr, Phoenix, AZ 85021-5217 | 2020-06-29 |
| 1558988246 | Cmj Recovery Az LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg A, Phoenix, AZ 85016-5922 | 2020-06-29 |
| 1720549009 | Rtc Management Group, LLC | Substance Abuse Rehabilitation Facility | 1340 E Desert Cove Ave, Phoenix, AZ 85020-1110 | 2019-03-28 |
| 1497227771 | Vogue Recovery Center Outpatient | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg C, Phoenix, AZ 85016-5922 | 2018-12-26 |
| 1780155077 | Pb Medical Group of Arizona, LLC | Substance Abuse Rehabilitation Facility | 3000 N 91st Ave, Phoenix, AZ 85037-4037 | 2018-12-11 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1891283149 | Bbc Whitton, LLC | Substance Abuse Rehabilitation Facility | 1106 E Whitton Ave, Phoenix, AZ 85014-5053 | 2018-04-23 |
| 1417456336 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St, Phoenix, AZ 85016-5922 | 2018-02-06 |
| 1992254338 | A Path of Resilience | Substance Abuse Rehabilitation Facility | 6102 S 37th Ln, Phoenix, AZ 85041-5021 | 2016-09-27 |
| Find all providers in PHOENIX | ||||
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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.