Organization
TRAUMA REENTRY INTERVENTION PREVENTION SUPPORTIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVION DE'JUAN CHAMBERLAIN (CHIEF EXECUTIVE OFFICER)
(909) 295-0351
Entity
Organization
Contact information
Practice address
161 W VICTORIA ST STE 255, LONG BEACH, CA 90805-2178
(909) 295-0351
Mailing address
161 W VICTORIA ST STE 255, LONG BEACH, CA 90805-2178
(909) 295-0351
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
05/19/2025
Last updated
07/10/2026
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