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CROSSROADS MIDTOWN SABG NPI 1700309879


NPI Information

NPI: 1700309879
Provider Name: CROSSROADS MIDTOWN SABG
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
3702 N 13TH AVE
PHOENIX, AZ
ZIP 85013
Phone: (602) 266-8400
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CROSSROADS MIDTOWN SABG is a substance abuse rehabilitation facility in Phoenix, AZ. The provider is 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. CROSSROADS MIDTOWN SABG NPI is 1700309879. The provider is registered as an organization entity type.

The provider's business location address is:

3702 N 13TH AVE
PHOENIX, AZ
ZIP 85013-677
Phone: (602) 266-8400

The provider's authorized official is John House .
The authorized official title is Program Coordinator and has the following contact phone number (602) 266-8400.

The enumeration date for this NPI number is 7/20/2017 and was last updated on 12/27/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation FacilityARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1870925MEDICAIDARIZONA

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: 4/28/2024

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