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General NPI Number Information
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NPI Number | 1437796851
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Entity Type | Organization
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Legal Business Name | ALLEN TEMPLE HEALTH & SOCIAL SERVICES MINISTRY
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 8501 INTERNATIONAL BLVD., C-105
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City | OAKLAND
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State | CA
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Zip | 94621-1549
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Country | US
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Telephone | 510-544-8947
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Fax | 510-544-8918
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Provider Business Mailing Address
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Address Line | 8501 INTERNATIONAL BLVD., C-105
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City | OAKLAND
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State | CA
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Zip | 94621-1549
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Country | US
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Telephone | 510-544-8947
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Fax | 510-544-8918
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GLORIA CROWELL
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Credential |
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Telephone | 510-544-8947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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