Provider Demographics
NPI: | 1639591209 |
---|---|
Name: | CRISIS SUPPORT SERVICES OF ALAMEDA COUNTY |
Entity Type: | Organization |
Organization Name: | CRISIS SUPPORT SERVICES OF ALAMEDA COUNTY |
Other - Org Name: | SUICIDE PREVENTION OF ALAMEDA COUNTY |
Other - Org Type: | Former Legal Business Name |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NANCY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SALAMY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMFT |
Authorized Official - Phone: | 510-420-2460 |
Mailing Address - Street 1: | PO BOX 3120 |
Mailing Address - Street 2: | |
Mailing Address - City: | OAKLAND |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94609 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 510-420-2460 |
Mailing Address - Fax: | 510-420-2461 |
Practice Address - Street 1: | 6117 MARTIN LUTHER KING JR WAY |
Practice Address - Street 2: | |
Practice Address - City: | OAKLAND |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94609-1240 |
Practice Address - Country: | US |
Practice Address - Phone: | 510-420-2460 |
Practice Address - Fax: | 510-420-2461 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-01-15 |
Last Update Date: | 2019-01-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |