Healthcare Provider Details

I. General information

NPI: 1164080933
Provider Name (Legal Business Name): BAY AREA COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959/67 SOLANO WAY
CONCORD CA
94520
US

IV. Provider business mailing address

390 40TH ST
OAKLAND CA
94609-2633
US

V. Phone/Fax

Practice location:
  • Phone: 925-676-9768
  • Fax: 925-676-9837
Mailing address:
  • Phone: 510-613-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL STANTON WARD
Title or Position: SENIOR DIRECTOR OF ADMINISTRATION
Credential:
Phone: 510-219-7451