Provider Demographics
NPI:1578839445
Name:CASCADE CREST TRANSITIONS
Entity Type:Organization
Organization Name:CASCADE CREST TRANSITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:GERMAIN
Authorized Official - Last Name:FIEVET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-408-7539
Mailing Address - Street 1:PO BOX 2278
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-2278
Mailing Address - Country:US
Mailing Address - Phone:866-357-6357
Mailing Address - Fax:866-442-4499
Practice Address - Street 1:640 NW PORTLAND AVENUE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701
Practice Address - Country:US
Practice Address - Phone:866-357-6357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility