Provider Demographics
NPI:1235301524
Name:HEALTHY COMMUNITIES, INCORPORATED
Entity Type:Organization
Organization Name:HEALTHY COMMUNITIES, INCORPORATED
Other - Org Name:HEALTHY OAKLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LANKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-858-7292
Mailing Address - Street 1:2580 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1160
Mailing Address - Country:US
Mailing Address - Phone:510-444-9655
Mailing Address - Fax:
Practice Address - Street 1:2580 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1160
Practice Address - Country:US
Practice Address - Phone:510-444-9655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center