Provider Demographics
NPI:1578873386
Name:BEHAVIORAL CROSSROADS RECOVERY LLC
Entity Type:Organization
Organization Name:BEHAVIORAL CROSSROADS RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YISROEL
Authorized Official - Middle Name:SHLOMO
Authorized Official - Last Name:GREENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-645-2500
Mailing Address - Street 1:205 WEST PARKWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-645-2500
Mailing Address - Fax:609-642-4373
Practice Address - Street 1:205 WEST PARKWAY DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-645-2500
Practice Address - Fax:609-642-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0246093Medicaid