Provider Demographics
NPI:1568693562
Name:CROSSROADS CENTERS OF FREDERICK
Entity Type:Organization
Organization Name:CROSSROADS CENTERS OF FREDERICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:301-696-1950
Mailing Address - Street 1:1890 N MARKET ST STE 301
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3033
Mailing Address - Country:US
Mailing Address - Phone:301-696-1950
Mailing Address - Fax:301-698-2661
Practice Address - Street 1:1890 N MARKET ST STE 301
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3033
Practice Address - Country:US
Practice Address - Phone:301-696-1950
Practice Address - Fax:301-698-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-07
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health