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General NPI Number Information
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NPI Number | 1033427109
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Entity Type | Organization
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Legal Business Name | MARTIN LUTHER KING JR. ELEMENTARY SCHOOL
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 960 10TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-3106
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Country | US
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Telephone | 510-879-1820
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Fax |
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Provider Business Mailing Address
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Address Line | 960 10TH ST
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City | OAKLAND
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State | CA
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Zip | 94607-3106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | ROMA GROVES
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Credential |
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Telephone | 510-879-1820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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