PACIFIC CREST TRAIL DETOX LLC
NPI 1043760838
Substance Abuse Rehabilitation Facility in Milwaukie, OR
About Pacific Crest Trail Detox Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PACIFIC CREST TRAIL DETOX LLC (NPI 1043760838) is a healthcare organization registered as a substance abuse rehabilitation facility in Milwaukie, Oregon and active in the NPI registry since October 2016. The organization holds 2 active CLIA laboratory certificates and lists Benjamin Randolph, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 38D2182402
Pacific Crest Trail Detox · Portland, ORCertificate of Waiver 38D2126404
Pacific Crest Trail Detox LLC · Milwaukie, ORFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Pacific Crest Trail Detox LLC's NPI number?
The NPI number for Pacific Crest Trail Detox LLC is 1043760838. It was assigned to this organization in the NPPES registry on October 5, 2016.
Where is Pacific Crest Trail Detox LLC located?
Pacific Crest Trail Detox LLC is located at 7708 SE Clackamas Rd, Milwaukie, OR 97267. The listed phone number is (503) 908-8875.
What is Pacific Crest Trail Detox LLC's specialty?
The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
Does Pacific Crest Trail Detox LLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Pacific Crest Trail Detox LLC accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Pacific Crest Trail Detox LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Pacific Crest Trail Detox LLC was last updated on October 5, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pacific Crest Trail Detox Llc · NPI 1043760838
Substance Abuse Rehabilitation Facility organization in Milwaukie, Oregon. Organization record, active in the CMS NPPES registry since October 5, 2016.
## Identity
- **NPI:** 1043760838 (Entity type: Organization)
- **Enumerated:** October 5, 2016
- **Primary specialty:** Substance Abuse Rehabilitation Facility · taxonomy 324500000X
- **Organization subpart:** No
- **Authorized official:** Benjamin Randolph, CEO
## Practice location
- **Address:** 7708 SE CLACKAMAS RD, Milwaukie, OR 97267-4405
- **Phone:** (503) 908-8875
## Record status
- **NPPES last updated:** October 5, 2016
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1043760838) · Data from the CMS NPPES public registry.