Healthcare Provider Details
I. General information
NPI: 1881149466
Provider Name (Legal Business Name): BAART PROGRAMS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2016
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1124 INTERNATIONAL BLVD
OAKLAND CA
94606-4331
US
IV. Provider business mailing address
1720 LAKEPOINTE DR STE 117
LEWISVILLE TX
75057-6425
US
V. Phone/Fax
- Phone: 510-533-0800
- Fax:
- Phone: 214-379-3300
- Fax: 214-853-9018
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRUCE
JARVIE
Title or Position: VP, TREASURER
Credential:
Phone: 214-379-3300