CROSSROADS ADDICTION SERVICES INC NPI 1841735750

NPI Information

NPI: 1841735750
Provider Name: CROSSROADS ADDICTION SERVICES, INC
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
1420 SW SAINT LUCIE WEST BLVD STE 106
PORT ST LUCIE, FL
ZIP 34986
Phone: (772) 242-5408
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CROSSROADS ADDICTION SERVICES, INC is an addiction medicine family medicine in Port St Lucie, FL. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. CROSSROADS ADDICTION SERVICES, INC NPI is 1841735750. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1420 SW SAINT LUCIE WEST BLVD STE 106
PORT ST LUCIE, FL
ZIP 34986-709
Phone: (772) 242-5408

The provider's authorized official is Theresa A Biemer .
The authorized official title is President and has the following contact phone number (772) 242-5408.

The enumeration date for this NPI number is 12/31/2016 and was last updated on 2/26/2020.

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	207QA0401X	Family Medicine	Addiction Medicine			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	1982716353	OTHER	PROVIDER NPI-T. BIEMER
2	1477580876	OTHER	MEDICAL DIRECTOR PROVIDER NPI-M. ADLEN
3	1861729824	OTHER	PROVIDER NPI-V. FERRARA

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: 5/5/2024

NPI Synchronization or Removal

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