Provider Demographics
NPI:1043429319
Name:UJIMA FAMILY RECOVERY SERVICES
Entity Type:Organization
Organization Name:UJIMA FAMILY RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHANK
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
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:510-236-3039
Mailing Address - Fax:
Practice Address - Street 1:1515 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-4505
Practice Address - Country:US
Practice Address - Phone:510-236-3134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility