Provider Demographics
NPI:1346430287
Name:NATIONAL COUNCIL ON ALCOHOLISM AND OTHER DRUG ADDICTIONS BAY AREA, INC
Entity Type:Organization
Organization Name:NATIONAL COUNCIL ON ALCOHOLISM AND OTHER DRUG ADDICTIONS BAY AREA, INC
Other - Org Name:NCADA-BA
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-296-9047
Mailing Address - Street 1:944 MARKET ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4000
Mailing Address - Country:US
Mailing Address - Phone:415-296-9900
Mailing Address - Fax:415-296-0626
Practice Address - Street 1:944 MARKET ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4000
Practice Address - Country:US
Practice Address - Phone:415-296-9900
Practice Address - Fax:415-296-0626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38-005-01-100251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health