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General NPI Number Information
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NPI Number | 1760700991
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Entity Type | Organization
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Legal Business Name | BAY AREA COMMUNITY RESOURCES, INC.
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 599 WILLIAM AVE ROOMS 3A, 3B AND MULTI-PURPOSE ROOM 8
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City | LARKSPUR
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State | CA
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Zip | 94939-1554
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Country | US
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Telephone | 415-945-3770
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Fax |
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Provider Business Mailing Address
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Address Line | 171 CARLOS DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2005
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Country | US
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Telephone | 415-755-2305
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE EXECUTIVE DIRECTOR
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Name | MRS. MARY JO WILLIAMS
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Credential |
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Telephone | 415-755-2305
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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 |
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License Number State |
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