| Crossroads Community, Inc. | |
|
120 Banjo Ln Centreville MD 21617-1002 | |
| (410) 758-3050 | |
| (410) 758-1223 |
| Full Name | Crossroads Community, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 120 Banjo Ln, Centreville, Maryland |
| Authorized Official Name and Position | John F. Plaskon (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4107583050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Community, Inc. 120 Banjo Ln Centreville MD 21617-1002 Ph: (410) 758-3050 | Crossroads Community, Inc. 120 Banjo Ln Centreville MD 21617-1002 Ph: (410) 758-3050 |
| NPI Number | 1568912657 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568912657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5278 (Maryland) | Primary |
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