Provider Demographics
NPI:1316591811
Name:ROCKRIDGE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:ROCKRIDGE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROOPA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-568-1770
Mailing Address - Street 1:11030 JONES BRIDGE RD STE 301
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4560
Mailing Address - Country:US
Mailing Address - Phone:561-568-1770
Mailing Address - Fax:
Practice Address - Street 1:11030 JONES BRIDGE RD STE 301
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-4560
Practice Address - Country:US
Practice Address - Phone:561-568-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility