Basic Information
| Provider Information | |||||||||
| NPI: | 1730359845 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA HISPANIC COMMISSION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 CAPITOL AVE | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164435473 | ||||||||
| FaxNumber: | 9164431732 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 ELDRIDGE AVE STE 10A | ||||||||
| Address2: | |||||||||
| City: | VACAVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956886823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074498014 | ||||||||
| FaxNumber: | 7074498750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2008 | ||||||||
| LastUpdateDate: | 03/04/2008 | ||||||||
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| AuthorizedOfficialLastName: | HERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9164435473 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.