Provider Demographics
NPI:1750509162
Name:CONTRA COSTA COUNTY
Entity Type:Organization
Organization Name:CONTRA COSTA COUNTY
Other - Org Name:TRANSITIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-957-5405
Mailing Address - Street 1:50 DOUGLAS DR
Mailing Address - Street 2:SUITE 441
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 DOUGLAS DR
Practice Address - Street 2:SUITE 140
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4077
Practice Address - Country:US
Practice Address - Phone:925-957-5110
Practice Address - Fax:925-646-9595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTRA COSTA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-23
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA07HNOtherDHCS