Provider Demographics
NPI:1932469160
Name:CROSSROADS OF DELAWARE
Entity Type:Organization
Organization Name:CROSSROADS OF DELAWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBIERI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:302-652-1405
Mailing Address - Street 1:109 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-2236
Mailing Address - Country:US
Mailing Address - Phone:302-652-1405
Mailing Address - Fax:302-652-1403
Practice Address - Street 1:109 W 7TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2236
Practice Address - Country:US
Practice Address - Phone:302-652-1405
Practice Address - Fax:302-652-1403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE19941050373245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children