Provider Demographics
NPI:1417670217
Name:CROSSROADS RECOVERY SERVICES
Entity Type:Organization
Organization Name:CROSSROADS RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:SCHALLER
Authorized Official - Suffix:
Authorized Official - Credentials:BA,LAC
Authorized Official - Phone:765-775-6687
Mailing Address - Street 1:370 MILL SPGS
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:IN
Mailing Address - Zip Code:46128-9386
Mailing Address - Country:US
Mailing Address - Phone:765-775-6687
Mailing Address - Fax:
Practice Address - Street 1:101 SUZIE LN STE 6
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:IN
Practice Address - Zip Code:47918-2000
Practice Address - Country:US
Practice Address - Phone:765-775-6687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty