Provider Demographics
NPI:1104178342
Name:FRICK MIDDLE SCHOOL
Entity Type:Organization
Organization Name:FRICK MIDDLE SCHOOL
Other - Org Name:ALLIANT INTERNATIONAL UNIVERSITY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILNES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-628-9065
Mailing Address - Street 1:1440 BROADWAY STE 610
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2845 64TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2027
Practice Address - Country:US
Practice Address - Phone:510-729-7736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health