Provider Demographics
NPI:1427361963
Name:CRC HEALTH GROUP
Entity Type:Organization
Organization Name:CRC HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:LEHNHERR
Authorized Official - Suffix:
Authorized Official - Credentials:CADC I
Authorized Official - Phone:503-239-5738
Mailing Address - Street 1:2600 SE BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2916
Mailing Address - Country:US
Mailing Address - Phone:503-239-5738
Mailing Address - Fax:503-239-8429
Practice Address - Street 1:2600 SE BELMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2916
Practice Address - Country:US
Practice Address - Phone:503-239-5738
Practice Address - Fax:503-239-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR930320251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health