Basic Information
Provider Information
NPI: 1750857520
EntityType: 2
ReplacementNPI:  
OrganizationName: CRC RECOVERY, INC.
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Mailing Information
Address1: 6185 PASEO DEL NORTE STE 150
Address2:  
City: CARLSBAD
State: CA
PostalCode: 920111155
CountryCode: US
TelephoneNumber: 7607100819
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Practice Location
Address1: 522 S MAPLE RD
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City: ANN ARBOR
State: MI
PostalCode: 481033837
CountryCode: US
TelephoneNumber: 7345857970
FaxNumber: 7345857977
Other Information
ProviderEnumerationDate: 10/19/2018
LastUpdateDate: 10/19/2018
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AuthorizedOfficialLastName: MORRIS
AuthorizedOfficialFirstName: PETER
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AuthorizedOfficialTitleorPosition: PRESIDENT, CTC DIVISION
AuthorizedOfficialTelephone: 6157211297
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ACADIA HEALTHCARE COMPANY, INC.
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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