NPI: 1245886415
Provider Name: CROSSROADS, INC PURE HEART COUNSELING CENTER
Doing Business As: CROSSROADS, INC. PURE HEART COUNSELING CENTER
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 03D2176604
Address:
14240 N 43RD AVE
GLENDALE, AZ
ZIP 85306
Phone: (602) 263-5242
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CROSSROADS, INC PURE HEART COUNSELING CENTER is a rehabilitation and substance use disorder clinic center in Glendale, AZ. CROSSROADS, INC PURE HEART COUNSELING CENTER NPI is 1245886415. The provider is registered as an organization entity type.
The provider Is Doing Business As Crossroads, Inc. Pure Heart Counseling Center.
The provider's business location address is:
14240 N 43RD AVE
GLENDALE, AZ
ZIP 85306-511
Phone: (602) 263-5242
Fax: (602) 595-4434
The provider's authorized official is Chris Riley .
The authorized official title is Compliance Officer and has the following contact phone number (602) 263-5242.
The CLIA number assigned to this NPI record is 03D2176604 - community clinic with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/14/2019 and was last updated on 3/18/2021.