Basic Information
| Provider Information | |||||||||
| NPI: | 1063756617 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CROSSROADS TURNING POINTS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2265 LAVA LN | ||||||||
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| City: | ALAMOSA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 811013578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195895176 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2265 LAVA LN | ||||||||
| Address2: | |||||||||
| City: | ALAMOSA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 811013578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195895176 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2012 | ||||||||
| LastUpdateDate: | 11/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | RAMIREZ | ||||||||
| AuthorizedOfficialFirstName: | ROSARIO | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINICAL SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 7195895176 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CACIII | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | ACB.0007634 | CO | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.