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General NPI Number Information
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NPI Number | 1245430016
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Entity Type | Organization
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Legal Business Name | BEHAVIOR EMERGENCY RESPONSE TEAM
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3885
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Fax | 510-597-7171
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Provider Business Mailing Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3885
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Fax | 510-597-7171
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Authorized Official
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Title or Position | CONTROLLER
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Name | MS. COLLEEN REID
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Credential | CPA
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Telephone | 510-428-3467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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