Provider Demographics
NPI:1972911212
Name:CROSSROADS THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:CROSSROADS THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR
Authorized Official - Phone:304-637-4644
Mailing Address - Street 1:201 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-4105
Mailing Address - Country:US
Mailing Address - Phone:304-637-4644
Mailing Address - Fax:304-637-4645
Practice Address - Street 1:201 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-4105
Practice Address - Country:US
Practice Address - Phone:304-637-4644
Practice Address - Fax:304-637-4645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV1335261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation