CRC HEALTH OREGON, LLC (NPI# 1801947668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801947668 |
| Entity Type | Organization |
| Organization Name | CRC HEALTH OREGON, LLC |
| Other Organization Name | ALLIED HEALTH SERVICES PORTLAND |
| Practice Address |
324 Nw Davis St. Portland OR 97209 |
| Mailing Address |
6185 Paseo Del Norte Ste 150 Carlsbad CA 92011-1155 |
| Practice Telephone | 5032262203 |
| Practice Fax Number | 5032234231 |
| Mailing Telephone | 8552592288 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-02-20 |
| 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 | 028385 | 05 |
| Other Name | Type Code |
|---|---|
| Allied Health Services Portland | 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 |
| 1558412320 | Crc Health Oregon, LLC | Clinic/Center | 2600 Se Belmont St, Portland, OR 97214 | 2007-01-16 |
| 1184775967 | Crc Health Oregon, LLC | Clinic/Center | 10763 Sw Greenburg Rd, Ste 100, Tigard, OR 97223 | 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 |
324 NW DAVIS ST. |
| City | PORTLAND |
| State | OR |
| Zip Code | 97209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861933442 | Kevin Colbert | Counselor | 324 Nw Davis St., Portland, OR 97209 | 2017-03-15 |
| 1538600218 | Richard Davis | Counselor | 324 Nw Davis St., Portland, OR 97209 | 2017-03-15 |
| 1649630401 | Maria Killsnight | Counselor | 324 Nw Davis St., Portland, OR 97007 | 2016-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1518590538 | Julie Kay Igarta | Registered Nurse | 140 Northwest 14th Avenue, Portland, OR 97209 | 2020-02-18 |
| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1487202883 | Ann Tesora | Massage Therapist | 1320 Northwest 20th Avenue, Portland, OR 97209 | 2019-08-28 |
| 1972160455 | Vincent Martin | Massage Therapist | 210 Sw 17th Avenue, Portland, OR 97209 | 2019-05-21 |
| 1154896546 | Jennifer Marie Dodd | Social Worker | 1722 Nw Raleigh St Spc 412, Portland, OR 97209 | 2018-10-11 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1326408394 | Jennifer Blain | Counselor | 324 Nw Davis, Portland, OR 97209 | 2016-03-03 |
| 1275993255 | Lauren Dodson | Licensed Practical Nurse | 324 Nw Davis St, Portland, OR 97209 | 2016-03-03 |
| Find all providers in zip 97209 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1912233826 | Merrimack River Medical Services | Clinic/Center | 2300 Congress St, Portland, ME 04102-1908 | 2009-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386706919 | Marion County | Clinic/Center | 2045 Silverton Rd Ne, Salem, OR 97301-0100 | 2006-12-13 |
| 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.