MEDICARE: R & R EDUCATIONAL HOMES

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
1	1041C0700X	Clinical Social Worker	17248	CA

General Provider Information

NPI Number	:	1770782112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R & R EDUCATIONAL HOMES

Provider Business Mailing Address
First Line	:	PO BOX 1053
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-1053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 TAFT AVE
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-3449
Country	:	US
Telephone Number	:	510-235-3172
Fax Number	:

Authorized Official
Title or Position	:	ACSW
Name	:	GILDA BAIN-PEW
Credential	:
Telephone Number	:	510-235-3172

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	07/31/2007

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Directions to “R & R EDUCATIONAL HOMES ” Practice Location

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