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NPI Code Detail

MEDICARE: GREATER NEW BEGINNINGS YOUTH SERVICES

MEDICARE: GREATER NEW BEGINNINGS YOUTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility015600316CA

General Provider Information

NPI Number : 1487187951
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER NEW BEGINNINGS YOUTH SERVICES
Provider Business Mailing Address
First Line : 1625 FILBERT ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-2890
Country : US
Telephone Number : 510-663-9092
Fax Number :
Provider Business Practice Location Address
First Line : 1625 FILBERT ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-2890
Country : US
Telephone Number : 510-663-9092
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : KENNETH PORTER
Credential :
Telephone Number : 510-719-3950
Provider Enumeration Date : 04/11/2017
Last Update Date : 02/12/2026

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Directions to “GREATER NEW BEGINNINGS YOUTH SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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