Provider Demographics
NPI:1124535570
Name:FELTON INSTITUTE
Entity Type:Organization
Organization Name:FELTON INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCE & OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-844-8244
Mailing Address - Street 1:1005 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1148
Mailing Address - Country:US
Mailing Address - Phone:510-844-8244
Mailing Address - Fax:
Practice Address - Street 1:24301 SOUTHLAND DR STE 600
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1554
Practice Address - Country:US
Practice Address - Phone:415-474-7310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FELTON INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-08
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health