Provider Demographics
NPI:1497277800
Name:CROSSROADS PROGRAMS
Entity Type:Organization
Organization Name:CROSSROADS PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KOPCHO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:609-880-0210
Mailing Address - Street 1:610 BEVERLY RANCOCAS RD
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-3736
Mailing Address - Country:US
Mailing Address - Phone:609-880-0210
Mailing Address - Fax:609-880-0230
Practice Address - Street 1:42 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-2003
Practice Address - Country:US
Practice Address - Phone:609-880-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities