Organization
CROSSROADS OF PELLA
Active
Parent organization
CROSSROADS OF PELLA
Other names
The Edge of Recovery
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROSSROADS OF PELLA
Authorized official
MS. DEBORAH EMILY KAY MS ACADC (CLINICAL DIRECTOR)
(641) 780-1087
Entity
Organization
Contact information
Practice address
103 NORTH 3RD STREET, OSKALOOSA, IA 52577
(641) 676-4060
(641) 676-3721
Mailing address
712 UNION STREET, PELLA, IA 50219
(641) 628-1212
(641) 628-3181
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1339
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1339
ADULT AND JUVENILE LEVEL I SUBSTANCE ABUSE TREATMENT SERVICES
IA
Enumeration date
09/22/2010
Last updated
09/22/2010
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