Provider Demographics
NPI:1073805602
Name:R AND R EDUCATIONAL HOMES
Entity type:Organization
Organization Name:R AND R EDUCATIONAL HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:COPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-541-4321
Mailing Address - Street 1:4501 TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-3449
Mailing Address - Country:US
Mailing Address - Phone:510-235-3172
Mailing Address - Fax:510-235-0755
Practice Address - Street 1:4505 TAFT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804
Practice Address - Country:US
Practice Address - Phone:510-235-3172
Practice Address - Fax:510-235-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children