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General NPI Number Information
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NPI Number | 1083886485
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Entity Type | Organization
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Legal Business Name | BAY AREA COMMUNITY RESOURCES, INC
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 13201 SAN PABLO AVE SUITE 205
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City | SAN PABLO
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State | CA
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Zip | 94806-3952
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Country | US
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Telephone | 510-235-2887
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Fax | 510-235-2563
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Provider Business Mailing Address
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Address Line | 13201 SAN PABLO AVE SUITE 205
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City | SAN PABLO
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State | CA
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Zip | 94806-3952
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Country | US
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Telephone | 510-235-2887
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Fax | 510-235-2563
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Authorized Official
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Title or Position | CHIEF PROGRAM OFFICER
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Name | DONALD BRUCE BLASKY
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Credential |
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Telephone | 415-755-2311
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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 | 990322
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License Number State | CA
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