Provider Demographics
NPI:1851093397
Name:WILTON CROSS, INC.
Entity Type:Organization
Organization Name:WILTON CROSS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-406-9347
Mailing Address - Street 1:31 BOG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WASSAIC
Mailing Address - State:NY
Mailing Address - Zip Code:12592-2527
Mailing Address - Country:US
Mailing Address - Phone:646-406-9347
Mailing Address - Fax:
Practice Address - Street 1:10770 N 46TH ST STE A1200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-3485
Practice Address - Country:US
Practice Address - Phone:646-406-9347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty