CRC Health Oregon

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CRC HEALTH OREGON

Practice address

6185 Paseo del Norte
Ste 150
Carlsbad, CA 92011-1152

Phone

(855) 259-2288

Fax

(760) 918-8712

NPI assigned

Mar 31, 2016

Last updated

Mar 31, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicole Rose Ann Smith, LPNNPI 1689023368

Title

Nurse Supervisor

Phone

(503) 252-2949

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Smith, LPN

  • Licensed Practical Nurse
  • Portland, OR
  • NPI 1689023368
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1407219157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 NE 78TH CT",
            "address_2": "SUITE A-3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182823",
            "telephone_number": "503-252-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6185 PASEO DEL NORTE",
            "address_2": "STE 150",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111152",
            "telephone_number": "855-259-2288",
            "fax_number": "760-918-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRC HEALTH OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ROSE ANN",
        "authorized_official_title_or_position": "NURSE SUPERVISOR",
        "authorized_official_telephone_number": "503-252-2949",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028382",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CRC Ed Treatment LLC (Montecatini III)
• CRC Ed Treatment, LLC (Montecatini)
• CRC Ed Treatment, LLC (Montecatini)
• CRC Ed Treatment, LLC (Montecatini)
• CRC Ed Treatment, LLC (Montecatini)
• Creating a Positive Environment, Inc.
• Thomas J Crisman, PHD, MS
• Cece Crisp
• Doris Crofts, OTR/L, CHT
• Crown Point Healthcare LLC (Ardent Hospice)

• Substance Use Disorder Rehabilitation Clinic/Center in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.