| Residential, Behavioral Health Services | |
|
1 Bolivar Dr Berkeley CA 94710-2210 | |
| (510) 649-1177 | |
| (510) 649-0322 |
| Full Name | Residential, Behavioral Health Services |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 1 Bolivar Dr, Berkeley, California |
| Authorized Official Name and Position | Michael James Thomas (SENIOR DIRECTOR) |
| Authorized Official Contact | 5106491177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential, Behavioral Health Services 1 Bolivar Dr Berkeley CA 94710-2210 Ph: (510) 649-1177 | Residential, Behavioral Health Services 1 Bolivar Dr Berkeley CA 94710-2210 Ph: (510) 649-1177 |
| NPI Number | 1912054701 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912054701 | NPI | - | NPPES |
| 261QM0855X | Other | CA | ADOLESCENT, CHILD MS |
| 261QM0850X | Other | CA | ADULT MENTAL HEALTH |
| 322D00000X | Other | CA | RESIDENTIAL TREATMENT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | (California) | Primary |
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