# CHILD & ADOLESCENT RESOURCE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730317033
- **Authorized official:** DENISE B FELLOWS LCSW, CADC I (BUSINESS OWNER)
- **Authorized official phone:** (503) 472-2233

## Contact information

- **Practice address:** 1736 NE HEMBREE ST, MCMINNVILLE, OR 97128-3314
- **Practice address phone:** (503) 472-2233
- **Practice address fax:** (503) 472-2299
- **Mailing address:** 1736 NE HEMBREE ST, MCMINNVILLE, OR 97128-3314
- **Mailing address phone:** (503) 472-2233
- **Mailing address fax:** (503) 472-2299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 08-12-12 | OR | — |
| 1041C0700X | Clinical Social Worker | L4459 | OR | Yes |

## Other

- **Enumeration date:** 06/24/2009
- **Last updated:** 06/24/2009