Organization
CROSSROADS ADDICTION SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESA A BIEMER PA-C (PRESIDENT)
(772) 242-5408
Entity
Organization
Contact information
Practice address
1420 SW SAINT LUCIE WEST BLVD STE 106, PORT ST LUCIE, FL 34986-1709
(772) 242-5408
Mailing address
1420 SW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1709
(772) 242-5408
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477580876
MEDICAL DIRECTOR PROVIDER NPI-M. ADLEN
—
01
—
1861729824
PROVIDER NPI-V. FERRARA
—
01
—
1982716353
PROVIDER NPI-T. BIEMER
—
Enumeration date
12/31/2016
Last updated
02/26/2020
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