Provider Demographics
NPI:1629750955
Name:COMMUNITY REUNIFICATION PROJECT
Entity Type:Organization
Organization Name:COMMUNITY REUNIFICATION PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-300-1095
Mailing Address - Street 1:2411 FENTON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-3517
Mailing Address - Country:US
Mailing Address - Phone:619-300-1095
Mailing Address - Fax:888-744-5486
Practice Address - Street 1:6280 JACKSON DR STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-3434
Practice Address - Country:US
Practice Address - Phone:619-324-4893
Practice Address - Fax:888-744-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility