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General NPI Number Information
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NPI Number | 1740598473
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Entity Type | Organization
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Legal Business Name | COMMUNTIY RESEARCH FOUNDATION
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 835 3RD AVE STE C
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City | CHULA VISTA
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State | CA
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Zip | 91911-1352
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Country | US
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Telephone | 619-427-4661
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Fax |
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Provider Business Mailing Address
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Address Line | 835 3RD AVE STE C
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City | CHULA VISTA
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State | CA
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Zip | 91911-1352
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Country | US
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Telephone | 619-427-4661
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Fax |
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Authorized Official
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Title or Position | HUMAN RESOURCES REPRESENTATIVE
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Name | TESSA SANCHEZ
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Credential |
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Telephone | 619-275-0822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | VN183619
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License Number State | CA
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