Provider Demographics
NPI:1902405749
Name:CRC HEALTH TREATMENT CLINICS, LLC
Entity Type:Organization
Organization Name:CRC HEALTH TREATMENT CLINICS, LLC
Other - Org Name:PANHANDLE COMPREHENSIVE TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-716-9335
Mailing Address - Street 1:6183 PASEO DEL NORTE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1155
Mailing Address - Country:US
Mailing Address - Phone:855-259-2288
Mailing Address - Fax:
Practice Address - Street 1:4553 WATKINS STREET
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-2511
Practice Address - Country:US
Practice Address - Phone:904-438-7640
Practice Address - Fax:904-438-7656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACADIA HEALTHCARE COMPANY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-22
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251S00000XAgenciesCommunity/Behavioral Health