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General NPI Number Information
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NPI Number | 1700157328
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Entity Type | Organization
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Legal Business Name | COMMUNITY ALCOHOL AND DRUG REHABILITATION EFFORT, INC.
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 1413 BAILEY ST STE B
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City | HANFORD
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State | CA
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Zip | 93230-5943
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Country | US
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Telephone | 559-784-9309
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Fax | 559-782-4681
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Provider Business Mailing Address
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Address Line | 1413 BAILEY DRIVE SUITE B
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City | HANFORD
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State | CA
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Zip | 93230
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Country | US
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Telephone | 559-784-9309
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Fax | 559-782-4681
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANN CARLEY KONDA
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Credential | L.C.S.W.
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Telephone | 559-784-9309
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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 | 540024CN
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License Number State | CA
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