Healthcare Provider Details

I. General information

NPI: 1720204696
Provider Name (Legal Business Name): HUMANISTIC ALTERNATIVES TO ADDICTION RESEARCH AND TREATMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10850 MACARTHUR BLVD STE 200
OAKLAND CA
94605-5266
US

IV. Provider business mailing address

10850 MACARTHUR BLVD STE 200
OAKLAND CA
94605-5266
US

V. Phone/Fax

Practice location:
  • Phone: 510-875-2300
  • Fax: 510-875-2310
Mailing address:
  • Phone: 510-875-2300
  • Fax: 510-875-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number01-70
License Number StateCA

VIII. Authorized Official

Name: MICHELLE BURCH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 510-875-2300