# BONITA HOUSE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528080553
- **Authorized official:** LAURA EVON WEISSBERGER (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (510) 593-1950

## Contact information

- **Practice address:** 1410 BONITA AVE, BERKELEY, CA 94709-1909
- **Practice address phone:** (510) 899-7445
- **Practice address fax:** (510) 647-9408
- **Mailing address:** 2640 MARTIN LUTHER KING JR WAY, BERKELEY, CA 94704-3238
- **Mailing address phone:** (510) 714-0996
- **Mailing address fax:** (510) 647-9408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | CA | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | 011400072 | CA | — |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 08/02/2024