Provider Demographics
NPI:1528278652
Name:CROSS ROADS II DBA NEW DIRECTIONS OUTPATIENT
Entity type:Organization
Organization Name:CROSS ROADS II DBA NEW DIRECTIONS OUTPATIENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CDP, MRT
Authorized Official - Phone:509-838-0304
Mailing Address - Street 1:539 W SHARP AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2460
Mailing Address - Country:US
Mailing Address - Phone:509-838-0304
Mailing Address - Fax:509-462-0530
Practice Address - Street 1:539 W SHARP AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2460
Practice Address - Country:US
Practice Address - Phone:509-838-0304
Practice Address - Fax:509-462-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA32064700101YP2500X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty