CROSSROADS AT MOUNTAIN MEADOWS, INC. (NPI# 1366527335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366527335 |
| Entity Type | Organization |
| Organization Name | CROSSROADS AT MOUNTAIN MEADOWS, INC. |
| Other Organization Name | CROSSROADS GROUP HOME |
| Practice Address |
9528 Old White Horse Rd Greenville SC 29617-6914 |
| Mailing Address |
Po Box 14939 Greenville SC 29610-4939 |
| Practice Telephone | 8642460266 |
| Practice Fax Number | 8642460652 |
| Mailing Telephone | 8642460266 |
| Mailing Fax Number | 8642460652 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LORRAINE TURNER (CEO) |
| Authorized Official Telephone | 8642460266 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | SR-0008165001-CC | SC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 951MXH | 05 |
| Other Name | Type Code |
|---|---|
| Crossroads Group Home | Doing Business As Name - Organization |
| Street Address |
9528 OLD WHITE HORSE RD |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29617-6914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659960 | Ruby Donald Residential Care LLC | Nursing Care | 2 Ruby Donald Place, Greenville, SC 29617 | 2020-11-02 |
| 1063938637 | Emily Mcclung Williams | Counselor | 975 Foot Hill Rd, Greenville, SC 29617 | 2017-08-16 |
| 1043734585 | Aubrey R Grinstead | Counselor | 975 Foot Hills Road, Greenville, SC 29617 | 2017-07-26 |
| 1649711243 | Xavier Bailey | Counselor | 975 Foot Hills Rd, Greenville, SC 29617 | 2017-03-15 |
| 1932459682 | Marci Halberg | Pharmacist | 4102 Old Buncombe Road, Greenville, SC 29617 | 2012-09-10 |
| 1609133461 | Tiffany Ann Prasertkul | Social Worker | 975 Foothills Road, Greenville, SC 29617 | 2012-04-18 |
| 1669534004 | A Child's Haven, Inc. | Community/Behavioral Health | 20 Martin Dr., Greenville, SC 29617 | 2006-12-14 |
| 1487755104 | John Richard Fuzia | Dentist | 534 Sulphur Springs Rd, Greenville, SC 29617 | 2006-09-26 |
| 1992341135 | Ohio Valley Physicians Inc | Family Medicine | 975 Foot Hills Rd, Greenville, SC 29617 | 2019-11-22 |
| 1699252148 | Ginger Mccleer | Nurse Practitioner | 600 Sulphur Springs Rd, Greenville, SC 29617 | 2018-07-26 |
| Find all providers in zip 29617 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467892661 | Doretha Community Development | Residential Treatment Facility, Emotionally Disturbed Children | 3313 Brookline Ct, Greenville, NC 27834-8498 | 2013-07-02 |
| 1093968836 | A Second Chance,inc | Residential Treatment Facility, Emotionally Disturbed Children | 1209 Duce Dr, Greenville, NC 27834-6566 | 2008-10-24 |
| 1336316892 | Noacin, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 924 Ellery Dr, Greenville, NC 27834-0066 | 2008-05-14 |
| 1396927976 | Healthplus Therapeutic Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 205 Greenbriar Dr, Greenville, NC 27834-9699 | 2007-12-05 |
| 1235328881 | My Savior Family Care Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Briarcliff Dr, Greenville, NC 27834-4948 | 2007-10-19 |
| 1497963136 | Divine Guidance Integrative Services | Residential Treatment Facility, Emotionally Disturbed Children | 321 Scottish Ct, Greenville, NC 27858-8974 | 2007-05-18 |
| 1326254582 | Divine Guidance Integrative Services | Residential Treatment Facility, Emotionally Disturbed Children | 1306 Dusk Ct, Greenville, NC 27834-7785 | 2007-05-15 |
| 1629293592 | Dream Provider Care Services | Residential Treatment Facility, Emotionally Disturbed Children | 2272 Briley Rd, Greenville, NC 27834-8909 | 2007-04-16 |
| 1699804302 | Cascade Behavioral Treatment Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 325 Oak Grove Ave, Greenville, NC 27834-1124 | 2007-03-06 |
| 1720116072 | Infinity Options Residential Facility | Residential Treatment Facility, Emotionally Disturbed Children | 122 Fletcher Pl, Greenville, NC 27858-4723 | 2007-03-01 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29617 |
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| 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.