Organization
CROSSROADS TREATMENT CENTER OF ASHLAND, PSC
Active
Other names
Crossroads Treatment Center of Ashland
Organization subpart
No
Provider details
NPI number
Authorized official
RUPERT JAMES MCCORMAC IV (CEO)
(800) 805-6989
Entity
Organization
Contact information
Practice address
1220 GREENUP AVE, ASHLAND, KY 41101-7525
(606) 393-1165
(606) 393-1775
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
—
KY
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2800X
Methadone Clinic
—
KY
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810586
STATE LICENSE
KY
Enumeration date
03/28/2018
Last updated
06/06/2024
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