Provider Demographics
NPI:1528518347
Name:CROSSROADS TO RECOVERY LLC
Entity type:Organization
Organization Name:CROSSROADS TO RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-338-8373
Mailing Address - Street 1:911 N BUFFALO DR
Mailing Address - Street 2:SUITE #213
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0379
Mailing Address - Country:US
Mailing Address - Phone:702-978-8000
Mailing Address - Fax:702-978-8001
Practice Address - Street 1:3035 S MARYLAND PKWY
Practice Address - Street 2:SUITE #110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2202
Practice Address - Country:US
Practice Address - Phone:702-978-8000
Practice Address - Fax:702-978-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health