Provider Demographics
NPI:1235447483
Name:COMMUNITY REHABILITATION AND EDUCATIONAL SERVICES
Entity Type:Organization
Organization Name:COMMUNITY REHABILITATION AND EDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GILDEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-353-4987
Mailing Address - Street 1:11875 DUBLIN BLVD
Mailing Address - Street 2:SUITE D169
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2843
Mailing Address - Country:US
Mailing Address - Phone:925-353-4987
Mailing Address - Fax:
Practice Address - Street 1:11875 DUBLIN BLVD
Practice Address - Street 2:SUITE D169
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2843
Practice Address - Country:US
Practice Address - Phone:925-353-4987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health