Provider Demographics
NPI:1760674238
Name:LUTHERAN CHURCH OF THE CROSS
Entity Type:Organization
Organization Name:LUTHERAN CHURCH OF THE CROSS
Other - Org Name:YOUTH EMERGENCY ASSISTANCE HOSTEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:HAWKINS
Authorized Official - Last Name:LEYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-206-7427
Mailing Address - Street 1:1744 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1514
Mailing Address - Country:US
Mailing Address - Phone:510-704-9867
Mailing Address - Fax:510-848-1456
Practice Address - Street 1:1744 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1514
Practice Address - Country:US
Practice Address - Phone:510-704-9867
Practice Address - Fax:510-848-1456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN CHURCH OF THE CROSS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health