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NPI Code Detail

MEDICARE: CRC HEALTH TREATMENT CLINICS, LLC

MEDICARE: CRC HEALTH TREATMENT CLINICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM2800XMethadone Clinic

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609470186
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRC HEALTH TREATMENT CLINICS, LLC
Provider Business Mailing Address
First Line : PO BOX 682669
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-2669
Country : US
Telephone Number : 760-710-0819
Fax Number : 877-552-0439
Provider Business Practice Location Address
First Line : 3928 SOUTH NOVA ROAD
Second Line :
City : PORT ORANGE
State : FL
Zip : 32127-4911
Country : US
Telephone Number : 386-822-9941
Fax Number : 386-788-4519
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN PHILLIP FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 11/25/2020
Last Update Date : 04/07/2026

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