Healthcare Provider Details

I. General information

NPI: 1972026672
Provider Name (Legal Business Name): ALZHEIMER'S SERVICES OF THE EAST BAY, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43326 MISSION BLVD STE 9
FREMONT CA
94539-5829
US

IV. Provider business mailing address

2320 CHANNING WAY
BERKELEY CA
94704-2202
US

V. Phone/Fax

Practice location:
  • Phone: 510-656-1329
  • Fax: 510-656-1418
Mailing address:
  • Phone: 510-644-8292
  • Fax: 510-540-6771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number550003551
License Number StateCA

VIII. Authorized Official

Name: MS. MICHEAL POPE
Title or Position: CE
Credential:
Phone: 510-644-8292