Provider Demographics
NPI:1326221565
Name:BAY AREA COMMUNITY RESOURCES, INC.
Entity Type:Organization
Organization Name:BAY AREA COMMUNITY RESOURCES, INC.
Other - Org Name:PHOENIX ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:BLASKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-755-2311
Mailing Address - Street 1:171 CARLOS DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2005
Mailing Address - Country:US
Mailing Address - Phone:415-444-5580
Mailing Address - Fax:
Practice Address - Street 1:160B N SAN PEDRO RD
Practice Address - Street 2:RM 7 AND RM9
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-4206
Practice Address - Country:US
Practice Address - Phone:415-491-0218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health