Organization
CROSSROADS TREATMENT CENTER OF NORTHERN KENTUCKY, PSC
Active
Other names
Crossroads Treatment Center of Northern Kentucky; Crossroads Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
RUPERT MCCORMAC MD (CHIEF EXECUTIVE OFFICER)
(800) 805-6989
Entity
Organization
Contact information
Practice address
1974 WALTON NICHOLSON PIKE, INDEPENDENCE, KY 41051-7906
(859) 359-5404
(859) 359-0739
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
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810538
STATE LICENSE
KY
Enumeration date
08/23/2017
Last updated
11/08/2024
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