Provider Demographics
NPI:1083471940
Name:LAO FAMILY COMMUNITY DEVELOPMENT, INC.
Entity Type:Organization
Organization Name:LAO FAMILY COMMUNITY DEVELOPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:CHAO
Authorized Official - Last Name:ROTHBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-533-8850
Mailing Address - Street 1:2325 E 12TH ST STE 226
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1014
Mailing Address - Country:US
Mailing Address - Phone:510-533-8850
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE STE 140
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2450
Practice Address - Country:US
Practice Address - Phone:510-788-2588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services