Organization
CLC, INC
Active
Other names
Clean Living Centers
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN C BURGESS PH, D. (EXECUTIVE DIRECTOR)
(503) 515-5247
Entity
Organization
Contact information
Practice address
1714 NE 72ND CIR, VANCOUVER, WA 98665-0586
(503) 515-5247
(360) 718-7949
Mailing address
8002 NE HIGHWAY 99, PMB 617, VANCOUVER, WA 98665-8876
(503) 515-5247
(360) 718-7949
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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