Healthcare Provider Details
I. General information
NPI: 1891127247
Provider Name (Legal Business Name): UJIMA FAMILY RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2013
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
369 E LELAND RD
PITTSBURG CA
94565-4911
US
IV. Provider business mailing address
1901 CHURCH LN
SAN PABLO CA
94806-3707
US
V. Phone/Fax
- Phone: 925-427-9100
- Fax: 925-427-9102
- Phone: 510-236-3139
- Fax: 510-236-3200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
RITA
B.
SCHANK
Title or Position: EXECUTIVE DIRECTOR
Credential: MPA
Phone: 510-236-3139