| NPI | 1154088177 |
|---|---|
| Doing Business As | CROSSROADS TREATMENT CENTER PADUCAH |
| Entity Type | Organization |
| Authorized Contact | RUPERT JAMES MCCORMAC President 864-527-3145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2021-11-24 |
| Last Update Date | 2021-11-24 |