Provider Demographics
NPI:1598121956
Name:CROSSROAD BEHAVIORAL HEALTHCARE, LLC
Entity Type:Organization
Organization Name:CROSSROAD BEHAVIORAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:NOYES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:919-223-4571
Mailing Address - Street 1:5850 GRANITE PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6748
Mailing Address - Country:US
Mailing Address - Phone:919-223-4571
Mailing Address - Fax:919-400-4852
Practice Address - Street 1:5850 GRANITE PKWY
Practice Address - Street 2:SUITE 215
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6748
Practice Address - Country:US
Practice Address - Phone:919-223-4571
Practice Address - Fax:919-400-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty