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CRC HEALTH OREGON LLC NPI 1932250719


NPI Information

NPI: 1932250719
Provider Name: CRC HEALTH OREGON, LLC

Doing Business As: ALLIED HEALTH SERVICES EAST

Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 38D1061623

Address:
6601 NE 78TH COURT, STE A3
PORTLAND, OR
ZIP 97218
Phone: (503) 252-3949
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CRC HEALTH OREGON, LLC is a methadone clinic center in Portland, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. CRC HEALTH OREGON, LLC NPI is 1932250719. The provider is registered as an organization entity type.
The provider Is Doing Business As Allied Health Services East.

The provider's business location address is:

6601 NE 78TH COURT, STE A3
PORTLAND, OR
ZIP 97218
Phone: (503) 252-3949
Fax: (503) 252-4027

The provider's authorized official is Brian Phillip Farley .
The authorized official title is Vp & Secretary and has the following contact phone number (615) 861-6000.

The CLIA number assigned to this NPI record is 38D1061623 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/10/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderOREGONNo
2261QM2800XClinic/CenterMethadoneYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1028382MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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