Basic Information
| Provider Information | |||||||||
| NPI: | 1962542589 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY RESEARCH FOUNDATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 410 COLORADO AVE APT A | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919104030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195851245 | ||||||||
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| Practice Location | |||||||||
| Address1: | 410 COLORADO AVE APT A | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919104030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195851245 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RAMIREZ | ||||||||
| AuthorizedOfficialFirstName: | SYLVIA | ||||||||
| AuthorizedOfficialMiddleName: | RUIZ | ||||||||
| AuthorizedOfficialTitleorPosition: | BILINGUAL COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 6195754687 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 320800000X | Y | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness |
No ID Information.