Provider Demographics
NPI:1598018897
Name:CONTRA COSTA ARC - LYNN CENTER
Entity Type:Organization
Organization Name:CONTRA COSTA ARC - LYNN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN-SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-439-9628
Mailing Address - Street 1:1340 ARNOLD DR STE 121
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1340 ARNOLD DR STE 121
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4189
Practice Address - Country:US
Practice Address - Phone:925-439-9628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LYNN CENTER - NEXT STEPS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health