CROSSROADS FOUNDATION (NPI# 1881819621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881819621 |
| Entity Type | Organization |
| Organization Name | CROSSROADS FOUNDATION |
| Practice Address |
3594 4th Ave San Diego CA 92103-4940 |
| Practice Telephone | 6192961151 |
| Practice Fax Number | 6192556407 |
| Mailing Telephone | 6192961151 |
| Mailing Fax Number | 6192556407 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. DORA MARIA COSTELLO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6192961151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 370002AN | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE PROVIDER CODE | 37-0001 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | CROSSROADS FOUNDATION, INC. | 1424 Houser Street, Muscatine, IA 52761 |
| Street Address |
3594 4TH AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174168611 | Janie Christine Nelson | Counselor | 3594 4th Ave, San Diego, CA 92103-4940 | 2019-11-07 |
| 1447719679 | Judith Ann Hilger | Peer Specialist | 3594 4th Ave, San Diego, CA 92103-4940 | 2019-03-18 |
| 1245704659 | Donna Marie Raynes | Peer Specialist | 3594 4th Ave, San Diego, CA 92103-4940 | 2019-01-18 |
| 1811461320 | Lauren Ash-donoho | Counselor | 3594 4th Ave, San Diego, CA 92103-4989 | 2019-01-17 |
| 1033699475 | Aja Renee Bordonaro | Counselor | 3594 4th Ave, San Diego, CA 92103-4940 | 2018-08-15 |
| 1144722554 | Diana Lynn Kendrick | Counselor | 3594 4th Ave, San Diego, CA 92103-4940 | 2018-03-01 |
| 1710489125 | Christie Ann Davis | Counselor | 3594 4th Ave, San Diego, CA 92103-4940 | 2018-03-01 |
| 1073015483 | Benai Ferguson | Peer Specialist | 3594 4th Ave, San Diego, CA 92103-4940 | 2018-03-01 |
| 1821590282 | Cynthia Lee Erickson | Peer Specialist | 3594 4th Ave, San Diego, CA 92103-4940 | 2018-03-01 |
| 1013415512 | Marlyn Kellogg | Counselor | 3594 4th Ave, San Diego, CA 92103-4940 | 2018-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| 1891320099 | Refresh Recovery LLC | Substance Abuse Rehabilitation Facility | 4141 Jutland Dr Ste 110, San Diego, CA 92117-3658 | 2020-03-08 |
| 1447804612 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 2821 B St, San Diego, CA 92102-2208 | 2019-07-26 |
| 1619531530 | La Jolla Recovery Inc | Substance Abuse Rehabilitation Facility | 2140 Hartford St, San Diego, CA 92110-1312 | 2019-04-25 |
| 1558835264 | Jfccm LLC | Substance Abuse Rehabilitation Facility | 6122 El Cajon Blvd, San Diego, CA 92115-3914 | 2019-01-15 |
| 1255801767 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 3025 Reynard Way, San Diego, CA 92103-5434 | 2018-11-27 |
| 1831681576 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4971 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-30 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| 1518458298 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4959 Cresita Dr, San Diego, CA 92115-2339 | 2018-05-29 |
| 1982108841 | Pathfinders of San Diego | Substance Abuse Rehabilitation Facility | 1530 Dale St, San Diego, CA 92102-1519 | 2018-03-23 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on CROSSROADS FOUNDATION.
| 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.