Organization
CROSSROADS HEALTH
Active
Other names
Crossroads Lake County Adolescent Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE IDEN (COO)
(440) 255-1700
Entity
Organization
Contact information
Practice address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
(440) 205-2417
Mailing address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
(440) 205-2417
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001318
MACSIS UNIQUE PROVIDER ID
OH
05
—
2069738
—
OH
05
—
2864093
—
OH
Enumeration date
04/06/2006
Last updated
07/19/2021
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