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General NPI Number Information
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NPI Number | 1881062644
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Entity Type | Organization
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Legal Business Name | CONTRA COSTA COUNTY BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 2425 BISSO LN
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City | CONCORD
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State | CA
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Zip | 94520-4897
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Country | US
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Telephone | 925-521-5763
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 BISSO LN STE 200
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City | CONCORD
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State | CA
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Zip | 94520-4886
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Country | US
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Telephone | 925-521-5763
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Fax |
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Authorized Official
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Title or Position | MH COMMUNITY SUPPORT WORKER 1
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Name | JENNIFER RAE GREWATS
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Credential |
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Telephone | 925-521-5777
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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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