Organization
CROSSROADS TREATMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLEY NELSON WHITTY-SANDAKER CDPT (CDPT INTERN)
(850) 218-0752
Entity
Organization
Contact information
Practice address
10828 GRAVELLY LAKE DR SW STE 204, LAKEWOOD, WA 98499-1346
(253) 473-7474
(253) 474-9724
Mailing address
10828 GRAVELLY LAKE DR SW STE 204, LAKEWOOD, WA 98499-1346
(253) 473-7474
(253) 474-9724
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60367121
WA
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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