Provider Demographics
NPI:1871968495
Name:CRA, INC
Entity type:Organization
Organization Name:CRA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VALETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-693-7494
Mailing Address - Street 1:4102 FARHILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-9301
Mailing Address - Country:US
Mailing Address - Phone:217-693-7494
Mailing Address - Fax:734-342-6402
Practice Address - Street 1:816 WYATT AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-3145
Practice Address - Country:US
Practice Address - Phone:217-735-5203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities