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General NPI Number Information
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NPI Number | 1699274969
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Entity Type | Organization
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Legal Business Name | BLUE ARROW BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 1025 ATLANTIC AVE STE 101
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City | ALAMEDA
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State | CA
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Zip | 94501-1188
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Country | US
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Telephone | 510-268-8120
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 ATLANTIC AVE STE 101
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City | ALAMEDA
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State | CA
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Zip | 94501-1188
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Country | US
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Telephone | 510-268-8120
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PETE PALLARES
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Credential |
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Telephone | 415-309-7981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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