Provider Demographics
NPI:1033326095
Name:UJIMA FAMILY RECOVERY SERVICES
Entity Type:Organization
Organization Name:UJIMA FAMILY RECOVERY SERVICES
Other - Org Name:UJIMA HOPE SOLANO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-236-3139
Mailing Address - Street 1:1901 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3707
Mailing Address - Country:US
Mailing Address - Phone:510-236-3139
Mailing Address - Fax:510-236-3200
Practice Address - Street 1:251 GEORGIA STREET
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590
Practice Address - Country:US
Practice Address - Phone:707-558-8500
Practice Address - Fax:707-558-8508
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UJIMA FAMILY RECOVERY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-17
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CA15-00005117261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health