Healthcare Provider Details

I. General information

NPI: 1851965180
Provider Name (Legal Business Name): CRASH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 CAMINO DEL RIO S STE 207
SAN DIEGO CA
92108-4108
US

IV. Provider business mailing address

4025 CAMINO DEL RIO S STE 207
SAN DIEGO CA
92108-4108
US

V. Phone/Fax

Practice location:
  • Phone: 619-297-5131
  • Fax:
Mailing address:
  • Phone: 619-297-5131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MARY HIMMELBERGER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 619-297-5131