Provider Demographics
NPI:1700157328
Name:COMMUNITY ALCOHOL AND DRUG REHABILITATION EFFORT, INC.
Entity Type:Organization
Organization Name:COMMUNITY ALCOHOL AND DRUG REHABILITATION EFFORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:CARLEY
Authorized Official - Last Name:KONDA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:559-784-9309
Mailing Address - Street 1:1413 BAILEY DRIVE SUITE B
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230
Mailing Address - Country:US
Mailing Address - Phone:559-784-9309
Mailing Address - Fax:559-782-4681
Practice Address - Street 1:1413 BAILEY ST STE B
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5943
Practice Address - Country:US
Practice Address - Phone:559-784-9309
Practice Address - Fax:559-782-4681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA540024CN261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder