Provider Demographics
NPI:1437160264
Name:CROSSROADS COUNSELING CENTERS, INC.
Entity Type:Organization
Organization Name:CROSSROADS COUNSELING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:320-214-8558
Mailing Address - Street 1:214 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3330
Mailing Address - Country:US
Mailing Address - Phone:320-214-8558
Mailing Address - Fax:320-235-2733
Practice Address - Street 1:214 4TH ST SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3330
Practice Address - Country:US
Practice Address - Phone:320-214-8558
Practice Address - Fax:320-235-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)