| Child & Adolescent Resource Center, Llc | |
|
1736 Ne Hembree St Mcminnville OR 97128-3314 | |
| (503) 472-2233 | |
| (503) 472-2299 |
| Full Name | Child & Adolescent Resource Center, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1736 Ne Hembree St, Mcminnville, Oregon |
| Authorized Official Name and Position | Denise B Fellows (BUSINESS OWNER) |
| Authorized Official Contact | 5034722233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child & Adolescent Resource Center, Llc 1736 Ne Hembree St Mcminnville OR 97128-3314 Ph: (503) 472-2233 | Child & Adolescent Resource Center, Llc 1736 Ne Hembree St Mcminnville OR 97128-3314 Ph: (503) 472-2233 |
| NPI Number | 1730317033 |
|---|---|
| Provider Enumeration Date | 06/24/2009 |
| Last Update Date | 06/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730317033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 08-12-12 (Oregon) | Secondary |
| 1041C0700X | Social Worker - Clinical | L4459 (Oregon) | Primary |
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