Healthcare Provider Details

I. General information

NPI: 1316314701
Provider Name (Legal Business Name): CENTERFORCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 SEMINARY AVE #101
OAKLAND CA
94621-4170
US

IV. Provider business mailing address

1904 FRANKLIN ST
OAKLAND CA
94612-2912
US

V. Phone/Fax

Practice location:
  • Phone: 510-638-3034
  • Fax: 510-638-3034
Mailing address:
  • Phone: 510-834-3457
  • Fax: 510-834-3418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LARRY D HILL
Title or Position: EXECUTIVE DIRECTOR
Credential: MPA
Phone: 510-834-3457