Healthcare Provider Details

I. General information

NPI: 1477700540
Provider Name (Legal Business Name): COMMUNITY RECOVERY RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 SUNRISE AVE 250
ROSEVILLE CA
95661-4567
US

IV. Provider business mailing address

PO BOX 6028
AUBURN CA
95604-6028
US

V. Phone/Fax

Practice location:
  • Phone: 916-787-4357
  • Fax: 916-787-4359
Mailing address:
  • Phone: 530-878-5166
  • Fax: 916-797-8979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number310017AN
License Number StateCA

VIII. Authorized Official

Name: WARREN DANIELS
Title or Position: CEO
Credential:
Phone: 530-273-9541