Provider Demographics
NPI:1598523383
Name:CROSSROADS HEALING CENTER, LLC
Entity Type:Organization
Organization Name:CROSSROADS HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LIC. PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MORRIGAN
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SALATRIK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, ATR
Authorized Official - Phone:248-219-7958
Mailing Address - Street 1:21569 CLOCHETTE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-5405
Mailing Address - Country:US
Mailing Address - Phone:248-219-7958
Mailing Address - Fax:
Practice Address - Street 1:21569 CLOCHETTE DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5405
Practice Address - Country:US
Practice Address - Phone:248-219-7958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)