Healthcare Provider Details
I. General information
NPI: 1285125906
Provider Name (Legal Business Name): A BETTER WAY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2018
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1926 E 19TH ST
OAKLAND CA
94606-4126
US
IV. Provider business mailing address
3200 ADELINE ST
BERKELEY CA
94703-2407
US
V. Phone/Fax
- Phone: 510-207-8825
- Fax:
- Phone: 510-601-0203
- Fax: 510-601-4002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
DONALD
CHANNER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW
Phone: 510-207-8825