Organization
NATIONAL CROSSROADS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE LAKE (DIRECTOR)
(713) 530-4728
Entity
Organization
Contact information
Practice address
4990 HOLLY DR, SAN DIEGO, CA 92113-2059
(619) 262-0868
Mailing address
4991 IMPERIAL AVE, SAN DIEGO, CA 92113-2063
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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