Provider Demographics
NPI:1760700991
Name:BAY AREA COMMUNITY RESOURCES, INC.
Entity Type:Organization
Organization Name:BAY AREA COMMUNITY RESOURCES, INC.
Other - Org Name:SAN ANDREAS HIGH SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-755-2305
Mailing Address - Street 1:171 CARLOS DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2005
Mailing Address - Country:US
Mailing Address - Phone:415-755-2305
Mailing Address - Fax:
Practice Address - Street 1:599 WILLIAM AVE
Practice Address - Street 2:ROOMS 3A, 3B AND MULTI-PURPOSE ROOM 8
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1554
Practice Address - Country:US
Practice Address - Phone:415-945-3770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health