Provider Demographics
NPI:1265553465
Name:UJIMA FAMILY RECOVER SERVICES
Entity type:Organization
Organization Name:UJIMA FAMILY RECOVER SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHANK
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:510-236-3139
Mailing Address - Street 1:1901 CHURCH LANE
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 1:180 E. LELAND RD.
Practice Address - Street 2:SUITES A&B
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4949
Practice Address - Country:US
Practice Address - Phone:925-427-9100
Practice Address - Fax:925-427-9102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UJIMA FAMILY RECOVER SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-03
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070008EN251S00000X
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health