Organization
CRC HEALTH OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ROSE ANN SMITH LPN (NURSE SUPERVISOR)
(503) 252-2949
Entity
Organization
Contact information
Practice address
6185 PASEO DEL NORTE, STE 150, CARLSBAD, CA 92011-1152
(855) 259-2288
(760) 918-8712
Mailing address
6601 NE 78TH CT, SUITE A-3, PORTLAND, OR 97218-2823
(503) 252-3949
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028382
—
OR
Enumeration date
03/31/2016
Last updated
03/31/2016
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