Provider Demographics
NPI:1396251229
Name:CROSSROADS RECOVERY CENTER, LLC
Entity type:Organization
Organization Name:CROSSROADS RECOVERY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETRANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-912-4490
Mailing Address - Street 1:155 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3196
Mailing Address - Country:US
Mailing Address - Phone:603-912-4490
Mailing Address - Fax:
Practice Address - Street 1:155 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3196
Practice Address - Country:US
Practice Address - Phone:603-912-4490
Practice Address - Fax:603-824-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health