Provider Demographics
NPI:1174279715
Name:BAY AREA ALLIANCE FOR YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:BAY AREA ALLIANCE FOR YOUTH AND FAMILY SERVICES
Other - Org Name:PALO VERDE HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MANDAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-685-8156
Mailing Address - Street 1:3021 CITRUS CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2692
Mailing Address - Country:US
Mailing Address - Phone:925-609-6990
Mailing Address - Fax:
Practice Address - Street 1:4350 PALO VERDE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6332
Practice Address - Country:US
Practice Address - Phone:925-609-6990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children