Organization
CROSSROADS SUPPORT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JOHNSON (PRESIDENT)
(919) 736-9242
Entity
Organization
Contact information
Practice address
1316 WAYNE MEMORIAL DRIVE, SUITE C, GOLDSBORO, NC 27534-2253
(919) 736-9242
(919) 736-9299
Mailing address
PO BOX 251, GOLDSBORO, NC 27533-0251
(919) 736-9242
(919) 736-9299
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC 1678
NC
374U00000X
Home Health Aide
HC 1678
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408924
—
NC
05
—
6600650
—
NC
05
—
7211500
—
NC
05
—
8300562
—
NC
Enumeration date
09/01/2006
Last updated
07/09/2012
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