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Organization

CROSSROADS WELLNESS LLC

Active
Parent organization
CROSSROADS WELLNESS LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CROSSROADS WELLNESS LLC
Authorized official
MS. MEGAN JOY DEVAUGHN (PARTNER)
(443) 484-6408
Entity
Organization

Contact information

Practice address
1103 N STRICKER ST, BALTIMORE, MD 21217-2241
(410) 697-5502
(410) 457-9420
Mailing address
17331 BUSHLAND RD, PARKTON, MD 21120-9476
(443) 484-6408

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QR0400X
Rehabilitation Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
06/08/2022
Last updated
04/02/2024
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