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NPI Code Detail

MEDICARE: CRC HEALTH GROUP, INC

MEDICARE: CRC HEALTH GROUP, INC
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
1261QM2800XMethadone Clinic37-15CA

General Provider Information

NPI Number : 1609997865
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRC HEALTH GROUP, INC
Provider Business Mailing Address
First Line : 7020 FRIARS RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1126
Country : US
Telephone Number : 619-718-9890
Fax Number :
Provider Business Practice Location Address
First Line : 7020 FRIARS RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1126
Country : US
Telephone Number : 619-718-9890
Fax Number :
Authorized Official
Title or Position : OTD DIVISION PRESIDENT
Name : MR. PHIL HERSCHMAN
Credential :
Telephone Number : 760-918-8700
Provider Enumeration Date : 04/03/2007
Last Update Date : 08/22/2020

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1942420138 — CRC HEALTH GROUP
Practice Location Address:
7020 FRIARS RD
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92108-1126
Practice Phone: 619-718-9890
Practice Fax:

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