Healthcare Provider Details

I. General information

NPI: 1235383571
Provider Name (Legal Business Name): SENECA RESIDENTIAL AND DAY TREATMENT CENTER FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42875 GATEWOOD ST
FREMONT CA
94538-4131
US

IV. Provider business mailing address

2275 ARLINGTON DR
SAN LEANDRO CA
94578-1132
US

V. Phone/Fax

Practice location:
  • Phone: 510-656-6438
  • Fax:
Mailing address:
  • Phone: 510-317-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHERINE WEST
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 510-317-1444