=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447557749
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTWIND COMMUNITY SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2011
-----------------------------------------------------
Last Update Date | 02/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2901 MACDONALD AVE
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94804-3009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-233-2728
-----------------------------------------------------
Fax | 510-233-2053
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 605
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94808-0605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-233-2728
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. JANET LIA GATES
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 510-233-2728
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253J00000X
-----------------------------------------------------
Taxonomy Name | Foster Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------