CROSSROADS TREATMENT CENTER OF CHARLESTON PC NPI 1114460375

NPI Information

NPI: 1114460375
Provider Name: CROSSROADS TREATMENT CENTER OF CHARLESTON, PC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 42D2103742

Address:
2470 MALL DR
UNIT C
NORTH CHARLESTON, SC
ZIP 29406
Phone: (843) 207-4721
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CROSSROADS TREATMENT CENTER OF CHARLESTON, PC is a rehabilitation and substance use disorder clinic center in North Charleston, SC. CROSSROADS TREATMENT CENTER OF CHARLESTON, PC NPI is 1114460375. The provider is registered as an organization entity type.

The provider's business location address is:

2470 MALL DR
UNIT C
NORTH CHARLESTON, SC
ZIP 29406-514
Phone: (843) 207-4721

The provider's authorized official is Rupert J. Mccormac .
The authorized official title is Ceo and has the following contact phone number (828) 719-2753.

The CLIA number assigned to this NPI record is 42D2103742 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/21/2016 and was last updated on 11/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251S00000X	Community/Behavioral Health				No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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