Provider Demographics
NPI:1336267483
Name:CROSBY RECOVERY CENTER
Entity Type:Organization
Organization Name:CROSBY RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTTINGHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:BS,CDP,NCA1
Authorized Official - Phone:425-774-2955
Mailing Address - Street 1:3924 204TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-9368
Mailing Address - Country:US
Mailing Address - Phone:425-774-2955
Mailing Address - Fax:425-774-9589
Practice Address - Street 1:3924 204TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-9368
Practice Address - Country:US
Practice Address - Phone:425-774-2955
Practice Address - Fax:425-774-9589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty