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Organization
CROSSROADS TREATMENT CENTER OF LOUISVILLE, PSC
Active
Organization
CROSSROADS TREATMENT CENTER OF LOUISVILLE, PSC
Active
Other names
Crossroads Treatment Center of Louisville
Organization subpart
No
Provider details
NPI number
Authorized official
RUPERT MCCORMAC MD (CHIEF EXECUTIVE OFFICER)
(800) 805-6989
Entity
Organization
Contact information
Practice address
1700 CARGO CT, JEFFERSONTOWN, KY 40299-1938
(502) 749-6764
(502) 749-6843
Mailing address
PO BOX 749057, ATLANTA, GA 30374-9057
(800) 805-6989
(864) 558-8511
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810552
STATE LICENSE
KY
Enumeration date
08/23/2017
Last updated
07/12/2024
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