Provider Demographics
NPI:1386850295
Name:COMMUNITY HUMANSERVICES
Entity Type:Organization
Organization Name:COMMUNITY HUMANSERVICES
Other - Org Name:GENESIS HOUSE PERINATAL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-658-3811
Mailing Address - Street 1:2560 GARDEN RD
Mailing Address - Street 2:STE 201-B
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5338
Mailing Address - Country:US
Mailing Address - Phone:831-658-3811
Mailing Address - Fax:
Practice Address - Street 1:1152 SONOMA AVE
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-5218
Practice Address - Country:US
Practice Address - Phone:831-899-2436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270004AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility