Provider Demographics
NPI:1053738328
Name:CROSSROADS COUNSELING MINISTRIES
Entity type:Organization
Organization Name:CROSSROADS COUNSELING MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:ACCOUNTANT
Authorized Official - Phone:989-652-6121
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:163 CHURCHGROVE RD
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-0088
Mailing Address - Country:US
Mailing Address - Phone:989-652-0764
Mailing Address - Fax:
Practice Address - Street 1:163 CHURCHGROVE RD
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1025
Practice Address - Country:US
Practice Address - Phone:989-652-9764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty