Provider Demographics
NPI:1841408184
Name:BAY AREA COUNCIL ON DRUGS & ALCOHOL, INC.
Entity Type:Organization
Organization Name:BAY AREA COUNCIL ON DRUGS & ALCOHOL, INC.
Other - Org Name:BACODA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CORE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:281-212-2900
Mailing Address - Street 1:1300A BAY AREA BLVD. STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058
Mailing Address - Country:US
Mailing Address - Phone:281-212-2900
Mailing Address - Fax:281-212-2901
Practice Address - Street 1:1300A BAY AREA BLVD. STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-212-2900
Practice Address - Fax:281-212-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11988101Y00000X
TX6467101YA0400X
TX3691106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty