Organization
CROSSROADS CHURCH
Active
Other names
Charli's House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIM B HILL (CHAIRMAN OF BOARD)
(817) 925-2090
Entity
Organization
Contact information
Practice address
3151 N PIPER AVE, CASA GRANDE, AZ 85122-3725
(520) 560-4077
Mailing address
3151 N PIPER AVE, CASA GRANDE, AZ 85122-3725
(520) 560-4077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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