| Second Chance Ashland Center | |
|
1403 164th Ave San Leandro CA 94578-3123 | |
| (510) 481-8645 | |
| (510) 481-2413 |
| Full Name | Second Chance Ashland Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1403 164th Ave, San Leandro, California |
| Authorized Official Name and Position | Mark R Mcconville (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5107924357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Ashland Center 1403 164th Ave San Leandro CA 94578-3123 Ph: (510) 481-8645 | Second Chance Ashland Center 1403 164th Ave San Leandro CA 94578-3123 Ph: (510) 481-8645 |
| NPI Number | 1821290537 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821290537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0119 (California) | Primary |
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