Provider Demographics
NPI:1891491726
Name:VALLEJO TOGETHER
Entity Type:Organization
Organization Name:VALLEJO TOGETHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RAQUELMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-704-4723
Mailing Address - Street 1:PO BOX 6273
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6273
Mailing Address - Country:US
Mailing Address - Phone:707-655-7935
Mailing Address - Fax:
Practice Address - Street 1:FAIRGROUNDS DRIVE
Practice Address - Street 2:MOBILE BASIC NEEDS COALITION
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589
Practice Address - Country:US
Practice Address - Phone:510-228-9106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health