Provider Demographics
NPI:1194523852
Name:CROSSING PATHS LLC
Entity type:Organization
Organization Name:CROSSING PATHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:LEMONTE
Authorized Official - Last Name:TRUMBULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-481-0935
Mailing Address - Street 1:10114 N 116TH LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1693
Mailing Address - Country:US
Mailing Address - Phone:602-481-0935
Mailing Address - Fax:
Practice Address - Street 1:10114 N 116TH LN
Practice Address - Street 2:
Practice Address - City:YOUNGTOWN
Practice Address - State:AZ
Practice Address - Zip Code:85363-1693
Practice Address - Country:US
Practice Address - Phone:602-481-0935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ398176OtherAHCCCS PROVIDER ID
AZ336176OtherAHCCCS PROVIDER ID