Organization
CROSSROADS BEHAVIORAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMIAH THOMAS HARTLEY MA (CEO)
(816) 838-1808
Entity
Organization
Contact information
Practice address
1611 DEER RUN RD., OAK GROVE, MO 64075
(816) 838-1808
Mailing address
1611 DEER RUN RD, OAK GROVE, MO 64075-5210
(816) 838-1808
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
120123210218441
MO
Other
Enumeration date
01/06/2012
Last updated
05/14/2012
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