| Organization Name: | C & R EXECUTIVES, LLC |
| NPI Number: | 1134373574 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CATHY KAY LUDAHL (CLINICAL DIRECTOR) |
| Mailing Address: | 309 Oak St Kelso |
| State: | WA US |
| Postal Code: | 986262340 |
| Phone Number: | 3605777442 |
| Fax Number: | 3605777904 |
| NPI Enumeration Date: | 11/12/2008 |
| NPI Last Update Date: | 05/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 325/08 0535 00 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |