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Organization
Y TEAM
Active
Organization
Y TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATE GILLOLY (PROGRAM DIRECTOR)
(510) 262-6551
Entity
Organization
Contact information
Practice address
4175 LAKESIDE DR, RICHMOND, CA 94806-5774
(510) 262-6551
Mailing address
4963 STONERIDGE CT, OAKLAND, CA 94605-3872
(510) 632-5361
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
101YM0800X
CA
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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