Provider Demographics
NPI:1639421993
Name:CRC
Entity Type:Organization
Organization Name:CRC
Other - Org Name:RECOVERY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNCILOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:CAS
Authorized Official - Phone:714-542-3581
Mailing Address - Street 1:2101 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4007
Mailing Address - Country:US
Mailing Address - Phone:714-542-3581
Mailing Address - Fax:
Practice Address - Street 1:2101 E 1ST ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4007
Practice Address - Country:US
Practice Address - Phone:714-542-3581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization