Provider Demographics
NPI:1821458407
Name:UNITED CROSSROADS INC.
Entity Type:Organization
Organization Name:UNITED CROSSROADS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMANFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-0020
Mailing Address - Street 1:4000 W NORTHERN PKWY
Mailing Address - Street 2:W. NORTHERN PARKWAY PROFESSIONAL CENTER, STE B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4473
Mailing Address - Country:US
Mailing Address - Phone:410-601-0020
Mailing Address - Fax:
Practice Address - Street 1:4000 W NORTHERN PKWY
Practice Address - Street 2:W. NORTHERN PARKWAY PROFESSIONAL CENTER, STE B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4473
Practice Address - Country:US
Practice Address - Phone:410-601-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health