Provider Demographics
NPI:1336535947
Name:COALITION OF REGISTERED NURSES 4 HEALTHY COMMUNITIES
Entity Type:Organization
Organization Name:COALITION OF REGISTERED NURSES 4 HEALTHY COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CNS, RN
Authorized Official - Phone:951-779-1304
Mailing Address - Street 1:21495 DICKINSON RD
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-8421
Mailing Address - Country:US
Mailing Address - Phone:951-779-1304
Mailing Address - Fax:
Practice Address - Street 1:21495 DICKINSON RD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-8421
Practice Address - Country:US
Practice Address - Phone:951-779-1304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285031; 1888302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization