| Crossroads Addiction Recovery Effort, Llc | |
|
484 Tollage Crk Pikeville KY 41501 | |
| (606) 637-2273 | |
| (606) 637-7849 |
| Full Name | Crossroads Addiction Recovery Effort, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 484 Tollage Crk, Pikeville, Kentucky |
| Authorized Official Name and Position | Janelle White (CEO/OWNER) |
| Authorized Official Contact | 6064229330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Addiction Recovery Effort, Llc Po Box 157 Pikeville KY 41502-0157 Ph: (606) 218-6011 | Crossroads Addiction Recovery Effort, Llc 484 Tollage Crk Pikeville KY 41501 Ph: (606) 637-2273 |
| NPI Number | 1942667456 |
|---|---|
| Provider Enumeration Date | 01/28/2016 |
| Last Update Date | 08/12/2018 |
| Medicare PECOS PAC ID | 2567743164 |
|---|---|
| Medicare Enrollment ID | O20161219001939 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942667456 | NPI | - | NPPES |
| 7100416980 | Medicaid | KY |
| Provider Name | James Robert Hager |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1386617322 PECOS PAC ID: 8224066113 Enrollment ID: I20050802000052 |
| Provider Name | Bethany S Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962740969 PECOS PAC ID: 3476708363 Enrollment ID: I20130226000219 |
| Provider Name | Destiny Nykole Conn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831975622 PECOS PAC ID: 1456632066 Enrollment ID: I20240223003733 |
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