Crossroads Counseling Center
LBN: Trivium Llc
Crossroads Counseling Center is an health care organization with primary practice located at 17 S. River St. Suite 254, Janesville WI 53548-3863. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty.
Trivium Llc can be contacted via phone (608) 755-5260, or through Perry, Timothy F. via phone (608) 755-5260.
Contact Information
Primary practice address
17 S. River St. Suite 254
Janesville WI 53548-3863
Phone: (608) 755-5260
Fax: (608) 755-5267
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | ||
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 1265 | Wisconsin |
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X | 1265 | Wisconsin |
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X | 2868 | Wisconsin |
Profile Details
| NPI number | 1265450753 |
|---|---|
| LBN Legal business name | Trivium Llc |
| DBA Doing business as | Crossroads Counseling Center |
| Authorized official | Perry, Timothy F. MSSW, LCSW, LMFT |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Dec 11th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265450753 | NPPES |
| Wisconsin | MEDICAID | 42105900 |
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