Organization Name: | CRC HEALTH |
NPI Number: | 1316165749 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICKIE LYNN PERKINS (LPN) |
Mailing Address: | 111 Town Hollow Rd Cedar Bluff |
State: | VA US |
Postal Code: | 246099622 |
Phone Number: | 2769633554 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310500000X |
License Number: | 0002052423 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Intermediate Care Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |