Organization
CROSSROADS HEALTH
Active
Organization
CROSSROADS HEALTH
Active
Other names
Crossroads Lake County Adolescent Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE IDEN (COO)
(440) 255-1700
Entity
Organization
Contact information
Practice address
9220 MENTOR AVE, MENTOR, OH 44060-6412
(440) 354-9924
(877) 242-9583
Mailing address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0435072
—
OH
Enumeration date
02/05/2021
Last updated
01/29/2024
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