Healthcare Provider Details

I. General information

NPI: 1275364861
Provider Name (Legal Business Name): BAKERSFIELD RESCUE MISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/13/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 E 21ST ST
BAKERSFIELD CA
93305-5242
US

IV. Provider business mailing address

821 E 21ST ST
BAKERSFIELD CA
93305-5242
US

V. Phone/Fax

Practice location:
  • Phone: 661-325-0863
  • Fax: 661-325-0777
Mailing address:
  • Phone: 661-325-0863
  • Fax: 661-325-0777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL HENDERSON
Title or Position: CFO
Credential:
Phone: 661-325-0863