Provider Demographics
NPI:1831533041
Name:COMMUNITY VIOLENCE SOLUTIONS
Entity type:Organization
Organization Name:COMMUNITY VIOLENCE SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREES
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTILLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:510-307-4112
Mailing Address - Street 1:2101 VAN NESS ST
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3622
Mailing Address - Country:US
Mailing Address - Phone:510-237-0113
Mailing Address - Fax:510-237-0177
Practice Address - Street 1:3755 ALHAMBRA AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3833
Practice Address - Country:US
Practice Address - Phone:925-646-2305
Practice Address - Fax:925-646-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable