Provider Demographics
NPI:1891107116
Name:BAKER PLACE, INC
Entity Type:Organization
Organization Name:BAKER PLACE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BENEFITS
Authorized Official - Prefix:
Authorized Official - First Name:HANG
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-864-4655
Mailing Address - Street 1:673 SAN JOSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4914
Mailing Address - Country:US
Mailing Address - Phone:415-864-4655
Mailing Address - Fax:
Practice Address - Street 1:673 SAN JOSE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4914
Practice Address - Country:US
Practice Address - Phone:415-864-4655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty