Healthcare Provider Details
I. General information
NPI: 1285433870
Provider Name (Legal Business Name): BAY COMMUNITY SERVICES FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3130 BALFOUR RD STE D261
BRENTWOOD CA
94513-5515
US
IV. Provider business mailing address
3130 BALFOUR RD STE D261
BRENTWOOD CA
94513-5515
US
V. Phone/Fax
- Phone: 209-888-0238
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1000X |
| Taxonomy | Migrant Health Clinic/Center |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2400X |
| Taxonomy | Prison Health Clinic/Center |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MANISH
JAIN
Title or Position: PRESIDENT
Credential:
Phone: 209-888-0238