CROSSROADS TREATMENT CENTER OF DAWSONVILLE, PC (NPI# 1013434976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013434976 |
| Entity Type | Organization |
| Organization Name | CROSSROADS TREATMENT CENTER OF DAWSONVILLE, PC |
| Practice Address |
400 Dawson Commons Cir Ste 410 Dawsonville GA 30534-6269 |
| Mailing Address |
55 Beattie Pl Ste 810 Greenville SC 29601-2191 |
| Practice Telephone | 7063441263 |
| Practice Fax Number | 7062160034 |
| Mailing Telephone | 8645273145 |
| Mailing Fax Number | 8649900653 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | DR. RUPERT MCCORMAC (PRESIDENT) |
| Authorized Official Telephone | 8645273145 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Street Address |
400 DAWSON COMMONS CIR STE 410 |
| City | DAWSONVILLE |
| State | GA |
| Zip Code | 30534-6269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760622708 | Alan Marshall Metzel | Psychologist | 400 Dawson Commons Cir Ste 410, Dawsonville, GA 30534-6269 | 2009-03-04 |
| 1427656701 | Debora Mulugeta Fikremariam | Pharmacist | 400 Dawson Commons Cir Ste 410, Dawsonville, GA 30534-6269 | 2020-10-09 |
| 1629602479 | Mandeep K Mathaun | Licensed Practical Nurse | 400 Dawson Commons Cir Ste 410, Dawsonville, GA 30534-6269 | 2020-03-02 |
| 1801393277 | Shannon Jordan-sutton | Licensed Practical Nurse | 400 Dawson Commons Cir Ste 410, Dawsonville, GA 30534-6269 | 2018-04-11 |
| 1386157170 | Michelle Harrison | Counselor | 400 Dawson Commons Cir Ste 410, Dawsonville, GA 30534 | 2017-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780175331 | Sharon Redd | Occupational Therapist | 923 Riverbend Rd, Dawsonville, GA 30534 | 2018-05-18 |
| 1588103808 | Hearing Aid Solutions LLC | Hearing Instrument Specialist | 169 Hwy 9, Suite 100, Dawsonville, GA 30534 | 2017-02-20 |
| 1881140598 | Meagan Wilson | Registered Nurse | 6002 Ga 53, Suite 100, Dawsonville, GA 30534 | 2016-09-01 |
| 1265892293 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Hwy 52 East, Suite 110, Dawsonville, GA 30534 | 2016-03-03 |
| 1174961304 | Meredith Michelle Tatum Hulsey | Physician Assistant | 1080 Lumpkin Campground Road S, Suite 300, Dawsonville, GA 30534 | 2013-06-10 |
| 1932467115 | David Kenneth Woolsey | Chiropractor | 1100 Old Dawson Village Rd, Suite 010, Dawsonville, GA 30534 | 2012-04-25 |
| 1275836769 | Martha Leslie Baker | Counselor | 121 Old Dawson Village Rd E, Building 800, Unit 010, Dawsonville, GA 30534 | 2010-12-06 |
| 1982914073 | James Paul Whitcomb | Pharmacist | 751 Highway 53 East Fred's #1451, Dawsonville, GA 30534 | 2010-10-07 |
| 1801123302 | Sj&j Spine and Pain Group | Pain Medicine | 5959 Highway 53 W, Suite 100b, Dawsonville, GA 30534 | 2009-11-04 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| Find all providers in zip 30534 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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| 1275165755 | Walton County Treatment Center LLC | Clinic/Center | 3543 Highway 81 Ste 201, Loganville, GA 30052-4336 | 2020-02-12 |
| 1023640596 | Georgia Treatment Center LLC | Clinic/Center | 514 W Maple St Ste 1206, Cumming, GA 30040-2536 | 2020-02-12 |
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| 1952931164 | Southeast Georgia Treatment Center | Clinic/Center | 816 Professional Center Dr, Eastman, GA 31023-6734 | 2020-01-16 |
| 1508405150 | Woodstock Treatment Center LLC | Clinic/Center | 270 Heritage Walk, Woodstock, GA 30188-3875 | 2019-12-30 |
| 1588208128 | Narquest Healthcare Services, LLC | Clinic/Center | 1766 Memorial Dr Ste 3, Waycross, GA 31501-1098 | 2019-11-06 |
| 1619511334 | Douglasville Healthcare Services, LLC | Clinic/Center | 4158 Washington Rd Ste 4, Evans, GA 30809-4720 | 2019-11-06 |
| Find all providers with the same taxonomy | ||||
| City | DAWSONVILLE |
| Zip Code | 30534 |
Please comment or provide details below to improve the information on CROSSROADS TREATMENT CENTER OF DAWSONVILLE, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.