Healthcare Provider Details

I. General information

NPI: 1609336429
Provider Name (Legal Business Name): BAY AREA COMMUNITY RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MAINE AVE
RICHMOND CA
94804-2736
US

IV. Provider business mailing address

11175 SAN PABLO AVE
EL CERRITO CA
94530-2157
US

V. Phone/Fax

Practice location:
  • Phone: 510-231-1419
  • Fax: 510-215-4181
Mailing address:
  • Phone: 510-559-3009
  • Fax: 510-559-3069

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: DONALD BRUCE BLASKY
Title or Position: CHIEF PROGRAM OFFICER
Credential:
Phone: 415-755-2311