Organization
DAVIS STREET COMMUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALIA MCMILLEN (CHIEF FISCAL OFFICER)
(510) 347-4760
Entity
Organization
Contact information
Practice address
3081 TEAGARDEN ST, SAN LEANDRO, CA 94577-5720
(510) 347-4620
(510) 483-4486
Mailing address
3081 TEAGARDEN ST, SAN LEANDRO, CA 94577-5720
(510) 347-4620
(510) 483-4486
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
MFC 39862
CA
251S00000X
Community/Behavioral Health Agency
Primary
PSY25888
CA
Other
Enumeration date
07/16/2007
Last updated
12/03/2014
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