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General NPI Number Information
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NPI Number | 1275994907
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Entity Type | Organization
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Legal Business Name | PULZE RESIDENTIAL CARE GROUP, LLC
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 5901 CHRISTIE AVE SUITE 402
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City | EMERYVILLE
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State | CA
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Zip | 94608-1930
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Country | US
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Telephone | 949-388-9449
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16727
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City | IRVINE
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State | CA
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Zip | 92623-6727
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Country | US
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Telephone | 979-955-2262
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Fax | 979-955-9199
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Authorized Official
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Title or Position | CEO
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Name | ERIC CUNNINGHAM
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Credential |
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Telephone | 949-955-2262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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