C & R EXECUTIVES LLC NPI 1134373574

NPI Information

NPI: 1134373574
Provider Name: C & R EXECUTIVES, LLC

Doing Business As: A FIRST PLACE

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
309 OAK ST
KELSO, WA
ZIP 98626
Phone: (360) 577-7442
Get Directions

C & R EXECUTIVES, LLC is an addiction (substance use disorder) counselor in Kelso, WA. C & R EXECUTIVES, LLC NPI is 1134373574. The provider is registered as an organization entity type.
The provider Is Doing Business As A First Place.

The provider's business location address is:

309 OAK ST
KELSO, WA
ZIP 98626-340
Phone: (360) 577-7442
Fax: (360) 577-7904

The provider's authorized official is Cathy Kay Ludahl .
The authorized official title is Clinical Director and has the following contact phone number (360) 577-7442.

The enumeration date for this NPI number is 11/12/2008 and was last updated on 5/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	325/08 0535 00	WASHINGTON	No
2	251B00000X	Case Management		325/08 0535 00	WASHINGTON	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	08 053500	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2008862	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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