Healthcare Provider Details

I. General information

NPI: 1972807444
Provider Name (Legal Business Name): EAST BAY COMMUNITY RECOVERY PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22971 SUTRO ST
HAYWARD CA
94541-6514
US

IV. Provider business mailing address

2579 SAN PABLO AVE
OAKLAND CA
94612-1159
US

V. Phone/Fax

Practice location:
  • Phone: 510-318-6100
  • Fax: 510-728-8605
Mailing address:
  • Phone: 510-446-7100
  • Fax: 510-446-7191

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: MARTA MARIA ROSE
Title or Position: ASSOCIATE EXECUTIVE DIRECTOR
Credential:
Phone: 510-418-8521