Basic Information
| Provider Information | |||||||||
| NPI: | 1780872127 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CARNELES UNIDOS REFORMANDO ADICTOS INCORPORATE | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | C.U.R.A., INC. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4510 PERALTA BLVD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945365755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107133202 | ||||||||
| FaxNumber: | 5107130684 | ||||||||
| Practice Location | |||||||||
| Address1: | 37437 GLENMOOR DR | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945365731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107133200 | ||||||||
| FaxNumber: | 5107130684 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2007 | ||||||||
| LastUpdateDate: | 10/01/2015 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | LOCARIA | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | B. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 5107133202 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 010010AN | CA | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
ID Information
| ID | Type | State | Issuer | Description | 010010AN | 01 | CA | DRUG AND ALCOHOL TREATMEN | OTHER |