NPI Code Details Logo

NPI 1104761683

NPI 1104761683 : THE RESOURCE ENVIRONMENT FOR UNDERPRIVILEGED GROUPS ENTERPRISE, INC. : CARMICHAEL, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1104761683
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    THE RESOURCE ENVIRONMENT FOR UNDERPRIVILEGED GROUPS ENTERPRISE, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/21/2026
-----------------------------------------------------
    Last Update Date     |    04/21/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3631 WALNUT AVE 
-----------------------------------------------------
    City                 |    CARMICHAEL
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95608-3051
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    510-301-5809
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 19275 
-----------------------------------------------------
    City                 |    OAKLAND
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94619-0275
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    510-301-5809
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    EXECUTIVE DIRECTOR
-----------------------------------------------------
    Name                 |     JASON  HENDERSON 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    510-301-5809
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    322D00000X
-----------------------------------------------------
    Taxonomy Name        |    Emotionally Disturbed Childrens' Residential Treatment Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.