Provider Demographics
NPI:1740798206
Name:SOUTHERN ALAMEDA COUNTY COMITE FOR RAZA MENTAL HEALTH
Entity Type:Organization
Organization Name:SOUTHERN ALAMEDA COUNTY COMITE FOR RAZA MENTAL HEALTH
Other - Org Name:LA FAMILIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS & BILLING
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SALVATIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-300-3170
Mailing Address - Street 1:24301 SOUTHLAND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-1546
Mailing Address - Country:US
Mailing Address - Phone:510-300-3516
Mailing Address - Fax:510-291-9591
Practice Address - Street 1:2500 FAIRMONT DR
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1005
Practice Address - Country:US
Practice Address - Phone:510-881-5921
Practice Address - Fax:510-881-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health