Provider Demographics
NPI:1508063678
Name:OPPORTUNITY PLUS, INC.
Entity Type:Organization
Organization Name:OPPORTUNITY PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:NERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-848-5446
Mailing Address - Street 1:6915 NORFOLK RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1738
Mailing Address - Country:US
Mailing Address - Phone:510-848-5446
Mailing Address - Fax:
Practice Address - Street 1:6915 NORFOLK RD
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1738
Practice Address - Country:US
Practice Address - Phone:510-848-5446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-01
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA011441143322D00000X
CA015600490322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0000001A5OtherMEDI-CAL PROVIDER NUMBER