Provider Demographics
NPI:1598762239
Name:BAY AREA CARE TEAM, INC
Entity Type:Organization
Organization Name:BAY AREA CARE TEAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-753-0275
Mailing Address - Street 1:2505 TARAVAL STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2805
Mailing Address - Country:US
Mailing Address - Phone:415-753-0275
Mailing Address - Fax:415-753-0262
Practice Address - Street 1:2505 TARAVAL STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-2805
Practice Address - Country:US
Practice Address - Phone:415-753-0275
Practice Address - Fax:415-753-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2200301251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA369-2628-5OtherSTATE TAX ID
CAHH220000801OtherOASIS PROVIDER NUMBER
CAHHA57557FMedicaid
CA369-2628-5OtherSTATE TAX ID