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Organization

CHILD & ADOLESCENT RESOURCE CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE B FELLOWS LCSW, CADC I (BUSINESS OWNER)
(503) 472-2233
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
06/24/2009
Last updated
06/24/2009
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