Organization
CROSSROADS SKILLS DEV.INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES O EZE (EXECUTIVE DIRECTOR)
(323) 759-6224
Entity
Organization
Contact information
Practice address
1704 W MANCHESTER AVE, SUITE 105, LOS ANGELES, CA 90047-3034
(323) 759-6224
(323) 759-6189
Mailing address
1704 W MANCHESTER AVE, SUITE 105, LOS ANGELES, CA 90047-3034
(323) 759-6224
(323) 759-6189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
190508AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190508AN
AOD
CA
01
—
7210
DRUG MEDICAL
CA
Enumeration date
03/02/2007
Last updated
08/22/2020
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