Organization
C & R EXECUTIVES, LLC
Active
Other names
A First Place
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY KAY LUDAHL C.D.P. (CLINICAL DIRECTOR)
(360) 577-7442
Entity
Organization
Contact information
Practice address
309 OAK ST, KELSO, WA 98626-2340
(360) 577-7442
(360) 577-7904
Mailing address
PO BOX 1077, KELSO, WA 98626-0111
(360) 577-7442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08 053500
WA
251B00000X
Case Management Agency
325/08 0535 00
WA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
325/08 0535 00
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008862
—
WA
Enumeration date
11/12/2008
Last updated
05/21/2015
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