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General NPI Number Information
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NPI Number | 1275881492
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Entity Type | Organization
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Legal Business Name | LA CHEIM SCHOOL, INC.
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Dates
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Enumeration Date | 08/20/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 3031 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94609-3205
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Country | US
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Telephone | 510-596-8125
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Fax | 510-596-8352
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Provider Business Mailing Address
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Address Line | 3031 TELEGRAPH AVE
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City | OAKLAND
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State | CA
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Zip | 94609-3205
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Country | US
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Telephone | 510-596-8125
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Fax | 510-596-8352
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ADAM NELSON
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Credential | MD
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Telephone | 510-596-8125
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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 | MFC 50856
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License Number State | CA
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