Provider Demographics
NPI:1952118036
Name:RICHMOND EQUITY AND EMPOWERMENT INITIATIVE, INC.
Entity type:Organization
Organization Name:RICHMOND EQUITY AND EMPOWERMENT INITIATIVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:WYDERMYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:707-333-9336
Mailing Address - Street 1:770 SONOMA ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1500
Mailing Address - Country:US
Mailing Address - Phone:510-447-4070
Mailing Address - Fax:
Practice Address - Street 1:770 SONOMA ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-1500
Practice Address - Country:US
Practice Address - Phone:510-447-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHMOND EQUITY AND EMPOWERMENT INITIATIVE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-12
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage