Healthcare Provider Details

I. General information

NPI: 1881002541
Provider Name (Legal Business Name): UJIMA FAMILY RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12960 SAN PABLO AVE
RICHMOND CA
94805-1307
US

IV. Provider business mailing address

1901 CHURCH LN
SAN PABLO CA
94806-3707
US

V. Phone/Fax

Practice location:
  • Phone: 510-215-2280
  • Fax: 510-215-2283
Mailing address:
  • Phone: 510-236-3139
  • Fax: 510-236-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. RITA SCHANK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 510-236-3139