Provider Demographics
NPI:1457620007
Name:EAST BAY AGENCY FOR CHILDREN
Entity Type:Organization
Organization Name:EAST BAY AGENCY FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:VIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-655-4896
Mailing Address - Street 1:6117 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1240
Mailing Address - Country:US
Mailing Address - Phone:510-655-4896
Mailing Address - Fax:510-658-7140
Practice Address - Street 1:6117 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1240
Practice Address - Country:US
Practice Address - Phone:510-655-4896
Practice Address - Fax:510-658-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management