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General NPI Number Information
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NPI Number | 1477700540
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Entity Type | Organization
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Legal Business Name | COMMUNITY RECOVERY RESOURCES
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 730 SUNRISE AVE 250
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City | ROSEVILLE
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State | CA
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Zip | 95661-4567
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Country | US
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Telephone | 916-787-4357
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Fax | 916-787-4359
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Provider Business Mailing Address
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Address Line | PO BOX 6028
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City | AUBURN
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State | CA
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Zip | 95604-6028
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Country | US
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Telephone | 530-878-5166
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Fax | 916-797-8979
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Authorized Official
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Title or Position | CEO
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Name | WARREN DANIELS
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Credential |
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Telephone | 530-273-9541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 310017AN
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License Number State | CA
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