Provider Demographics
NPI:1912134651
Name:CROSSROADS FOR GROWTH INC.
Entity Type:Organization
Organization Name:CROSSROADS FOR GROWTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAJTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CCM, CDMS, CLCP
Authorized Official - Phone:201-661-8660
Mailing Address - Street 1:106 N FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1627
Mailing Address - Country:US
Mailing Address - Phone:201-661-8660
Mailing Address - Fax:201-661-8659
Practice Address - Street 1:106 N FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1627
Practice Address - Country:US
Practice Address - Phone:201-661-8660
Practice Address - Fax:201-661-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty