Crossroads Treatment Centers Tyler

LBN: Methadone Clinic Of East Texas Llc
Crossroads Treatment Centers Tyler is an health care organization with primary practice located at 1510 S Vine Ave , Tyler TX 75701-2826. The organization recently has 6 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Methadone, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Methadone is the primary health care specialty. Methadone Clinic Of East Texas Llc can be contacted via phone (800) 805-6989, or through Mccormac, Rupert via phone (800) 805-6898.

Contact Information

Primary practice address
1510 S Vine Ave Tyler TX 75701-2826
Phone: (800) 805-6989
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mccormac, Rupert
Phone: (800) 805-6898

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Methadone 261QM2800X 000039 Texas
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X Texas

Profile Details

NPI number 1104144088
LBN Legal business name Methadone Clinic Of East Texas Llc
DBA Doing business as Crossroads Treatment Centers Tyler
Authorized official Mccormac, Rupert
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2010
Last updated Jun 18th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104144088 NPPES
Texas MEDICAID 2121550

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