NPIMap

Organization Active NPI

CRC Health Oregon, LLC

  • Methadone Clinic
  • Portland, OR
National Provider Identifier
1801947668
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
CRC HEALTH OREGON, LLC
Practice address
324 NW Davis St.
Portland, OR 97209
Phone
(503) 226-2203
Fax
(503) 223-4231
NPI assigned
Jan 16, 2007
Organization subpart
Yes
Parent organization
ACADIA HEALTHCARE COMPANY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Brian Phillip Farley
Title
VP & Secretary
Phone
(615) 861-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X OR

Addresses

Primary practice location

324 NW Davis St.
Portland, OR 97209

Mailing address

6183 Paseo del Norte Ste 200
Carlsbad, CA 92011-1151
Phone (855) 259-2288

Other identifiers 1

IdentifierTypeStateIssuer
028385MedicaidOR

Other names 1

  • Allied Health Services Portland Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200121002225 OR Part B Supplier - Opioid Treatment Program (Otp) 0143655100 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, OR; Portland, OR; Salem, OR; Tigard, OR; Albany, OR

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
CRC Health Oregon16 organizations share this tax ID, including this one
Part of
Haven Behavioral Healthcare

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1801947668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 PASEO DEL NORTE STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111151",
            "telephone_number": "855-259-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 NW DAVIS ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "503-226-2203",
            "fax_number": "503-223-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRC HEALTH OREGON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA HEALTHCARE COMPANY, INC.",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028385",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Allied Health Services Portland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allied Health Services Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.