Provider Demographics
NPI:1659885440
Name:CONTRA COSTA COUNTY
Entity Type:Organization
Organization Name:CONTRA COSTA COUNTY
Other - Org Name:RESPITE SHELTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISCAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:DECESARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-957-5429
Mailing Address - Street 1:50 DOUGLAS DR STE 310E
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4003
Mailing Address - Country:US
Mailing Address - Phone:925-957-5429
Mailing Address - Fax:
Practice Address - Street 1:2047D ARNOLD INDUSTRIAL WAY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5342
Practice Address - Country:US
Practice Address - Phone:925-957-5429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTRA COSTA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care