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Organization

MAN TO MAN - URBAN YOUTH ADVOCATE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEWART PERRILLIAT (CEO)
(408) 750-4334
Entity
Organization

Contact information

Practice address
7200 BANCROFT AVE STE 266, OAKLAND, CA 94605-2465
(408) 750-4334
Mailing address
5416 SHALLOWS PL W, SANTA ROSA, CA 95409-5502
(408) 750-4334

Taxonomy

Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
251B00000X
Case Management Agency
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
251V00000X
Voluntary or Charitable Agency
Primary
253Z00000X
In Home Supportive Care Agency
373H00000X
Day Training/Habilitation Specialist

Other

Enumeration date
09/11/2024
Last updated
09/11/2024
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