Provider Demographics
NPI:1972772820
Name:COALITION TO REDUCE UNDERAGE DRINKING, INC.
Entity type:Organization
Organization Name:COALITION TO REDUCE UNDERAGE DRINKING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-391-4172
Mailing Address - Street 1:82500 US HIGHWAY 111
Mailing Address - Street 2:SUITE 4
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5661
Mailing Address - Country:US
Mailing Address - Phone:760-342-5959
Mailing Address - Fax:
Practice Address - Street 1:82500 US HIGHWAY 111
Practice Address - Street 2:SUITE 4
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5661
Practice Address - Country:US
Practice Address - Phone:760-342-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health