CRC HEALTH OREGON, LLC (NPI# 1184775967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184775967 |
| Entity Type | Organization |
| Organization Name | CRC HEALTH OREGON, LLC |
| Other Organization Name | ALLIED HEALTH SERVICES TIGARD |
| Practice Address |
10763 Sw Greenburg Rd Ste 100 Tigard OR 97223 |
| Mailing Address |
6185 Paseo Del Norte Ste 150 Carlsbad CA 92011-1155 |
| Practice Telephone | 5036848159 |
| Practice Fax Number | 5035980934 |
| Mailing Telephone | 8552592288 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | KIM SANDERSON (INTERIM PRESIDENT, CTC DIVISION) |
| Authorized Official Telephone | 8552592288 |
| Is Organization Subpart | Y |
| Parent Organization Name | ACADIA HEALTHCARE COMPANY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
OR | Ambulatory Health Care Facilities | |
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 028383 | 05 |
| Other Name | Type Code |
|---|---|
| Allied Health Services Tigard | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225241441 | Crc Health Oregon, LLC | Clinic/Center | 777 Murphy Rd, Medford, OR 97504-8425 | 2007-05-07 |
| 1801947668 | Crc Health Oregon, LLC | Clinic/Center | 324 Nw Davis St., Portland, OR 97209 | 2007-01-16 |
| 1558412320 | Crc Health Oregon, LLC | Clinic/Center | 2600 Se Belmont St, Portland, OR 97214 | 2007-01-16 |
| 1932250719 | Crc Health Oregon, LLC | Clinic/Center | 6601 Ne 78th Court, Ste A3, Portland, OR 97218 | 2007-01-16 |
| 1427397074 | Crc Health Oregon, LLC | Clinic/Center | 1160 Liberty St Se, Salem, OR 97302 | 2013-02-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CRC HEALTH OREGON, LLC | 6100 Tower Circle, Suite 1000, Franklin, TN 37067 |
| Street Address |
10763 SW GREENBURG RD STE 100 |
| City | TIGARD |
| State | OR |
| Zip Code | 97223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275154957 | Christopher Brent Bucar | Counselor | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2020-05-04 |
| 1831736255 | Allied Health Services | Counselor | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2019-12-04 |
| 1225672652 | Rachel M Borton-monaghan | Licensed Practical Nurse | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2019-10-29 |
| 1003389727 | Gretchen Anna Schneider | Registered Nurse | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2019-01-04 |
| 1558834416 | Scott Michael Munoz | Licensed Practical Nurse | 10763 Sw Greenburg Rd, Suite 100, Tigard, OR 97223 | 2019-01-03 |
| 1932686623 | Amanda Marie Nonamaker | Licensed Practical Nurse | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2018-07-25 |
| 1568952471 | Tiffany Leflore | Licensed Practical Nurse | 10763 Sw Greenburg Rd, Tigard, OR 97223 | 2018-05-16 |
| 1013419019 | Griselda Holden | Licensed Practical Nurse | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2018-03-06 |
| 1164924478 | Melinda Sue Borgman | Counselor | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2018-03-02 |
| 1205337516 | Kevin Gray | Counselor | 10763 Sw Greenburg Rd, Tigard, OR 97223-5492 | 2018-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386706919 | Marion County | Clinic/Center | 2045 Silverton Rd Ne, Salem, OR 97301-0100 | 2006-12-13 |
| 1992897193 | Ram Clinic Inc. | Clinic/Center | 3610 Ne 82nd Ave, Portland, OR 97220-5120 | 2006-09-28 |
| 1851808562 | Integrated Health Clinics Ne LLC | Clinic/Center | 3610 Ne 82nd Ave, Portland, OR 97220-5182 | 2018-01-03 |
| 1427397074 | Crc Health Oregon, LLC | Clinic/Center | 1160 Liberty St Se, Salem, OR 97302 | 2013-02-01 |
| 1710933379 | County of Jackson | Clinic/Center | 140 South Holly Street, Medford, OR 97501 | 2006-05-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.