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General NPI Number Information
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NPI Number | 1891491726
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Entity Type | Organization
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Legal Business Name | VALLEJO TOGETHER
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | FAIRGROUNDS DRIVE MOBILE BASIC NEEDS COALITION
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City | VALLEJO
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State | CA
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Zip | 94589
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Country | US
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Telephone | 510-228-9106
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6273
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City | VALLEJO
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State | CA
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Zip | 94591-6273
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Country | US
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Telephone | 707-655-7935
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Fax |
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Authorized Official
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Title or Position | OPERATIONS SPECIALIST
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Name | RAQUELMARIE CLARK
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Credential |
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Telephone | 707-704-4723
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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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