| Crossroads 1010 Llc | |
|
193908 Us Hwy 271 Antlers OK 74523 | |
| (580) 271-7080 | |
| (580) 298-2081 |
| Full Name | Crossroads 1010 Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 193908 Us Hwy 271, Antlers, Oklahoma |
| Authorized Official Name and Position | Jennifer Griffin (OWNER) |
| Authorized Official Contact | 5803177002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads 1010 Llc P.o. Bo 1012 Antlers OK 74523 Ph: (580) 271-7080 | Crossroads 1010 Llc 193908 Us Hwy 271 Antlers OK 74523 Ph: (580) 271-7080 |
| NPI Number | 1174072482 |
|---|---|
| Provider Enumeration Date | 09/27/2016 |
| Last Update Date | 11/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174072482 | NPI | - | NPPES |
| 200734990A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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