Provider Demographics
NPI:1942532544
Name:BAYVIEW HUNTERS POINT
Entity Type:Organization
Organization Name:BAYVIEW HUNTERS POINT
Other - Org Name:BROTHERS AGANST GUNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:415-468-5100
Mailing Address - Street 1:150 EXECUTIVE PARK BLVD STE 2800
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3311
Mailing Address - Country:US
Mailing Address - Phone:415-468-5100
Mailing Address - Fax:415-468-5104
Practice Address - Street 1:1618 REVERE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-2304
Practice Address - Country:US
Practice Address - Phone:415-920-7030
Practice Address - Fax:415-920-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management