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NPI Code Detail

MEDICARE: THE RESOURCE ENVIRONMENT FOR UNDERPRIVILEGED GROUPS ENTERPRISE, INC.

MEDICARE: THE RESOURCE ENVIRONMENT FOR UNDERPRIVILEGED GROUPS ENTERPRISE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility015600744CA

General Provider Information

NPI Number : 1033308812
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE RESOURCE ENVIRONMENT FOR UNDERPRIVILEGED GROUPS ENTERPRISE, INC.
Provider Business Mailing Address
First Line : PO BOX 19275
Second Line :
City : OAKLAND
State : CA
Zip : 94619-0275
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2726 GARDEN ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-1314
Country : US
Telephone Number : 510-301-5809
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : JASON HENDERSON
Credential :
Telephone Number : 510-301-5809
Provider Enumeration Date : 10/17/2007
Last Update Date : 04/05/2021

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Directions to “THE RESOURCE ENVIRONMENT FOR UNDERPRIVILEGED GROUPS ENTERPRISE, INC. ” Practice Location

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