| Boss Shelter Network Maa | |
|
258 W A St Hayward CA 94541-4850 | |
| (510) 732-5956 | |
| (510) 732-5954 |
| Full Name | Boss Shelter Network Maa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 258 W A St, Hayward, California |
| Authorized Official Name and Position | Donald Ivy Frazier (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5106491935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boss Shelter Network Maa 1918 University Ave Ste 2a Berkeley CA 94704-3263 Ph: (510) 649-1930 | Boss Shelter Network Maa 258 W A St Hayward CA 94541-4850 Ph: (510) 732-5956 |
| NPI Number | 1407067846 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 01/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407067846 | NPI | - | NPPES |
| 8134 | Other | CA | MEDI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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