Organization
CROSSROADS TREATMENT CENTER OF PETERSBURG, PC
Active
Other names
Crossroads Treatment Center of Petersburg
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUPERT J. MCCORMAC IV MD (CEO)
(800) 805-6989
Entity
Organization
Contact information
Practice address
10543 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(800) 805-6989
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
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2800X
Methadone Clinic
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/23/2016
Last updated
09/03/2024
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