Provider Demographics
NPI:1013133305
Name:CROSSROADS YOUTH AND FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:CROSSROADS YOUTH AND FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:D
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-292-6440
Mailing Address - Street 1:1650 W TECUMSEH RD
Mailing Address - Street 2:500
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8271
Mailing Address - Country:US
Mailing Address - Phone:405-321-0240
Mailing Address - Fax:
Practice Address - Street 1:1650 W TECUMSEH RD
Practice Address - Street 2:500
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8271
Practice Address - Country:US
Practice Address - Phone:405-321-0240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKBMedicaid