Organization
COMMUNITY RESEARCH FOUNDATION, INC.
Active
Other names
South Bay IMPACT
Organization subpart
No
Provider details
NPI number
Authorized official
JACK FARMER (CHIEF ADMINISTRATIVE OFFICER)
(619) 275-0822
Entity
Organization
Contact information
Practice address
855 3RD AVE STE 1110, CHULA VISTA, CA 91911-1350
(619) 934-5770
Mailing address
1202 MORENA BLVD, SAN DIEGO, CA 92110-3841
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37RR
—
CA
Enumeration date
11/13/2017
Last updated
12/05/2022
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