Organization
AGESONG INC
Active
Parent organization
AGESONG INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AGESONG INC
Authorized official
MS. DIANA J CHANG MFT TRAINEE (MFT INTERN)
(209) 403-3748
Entity
Organization
Contact information
Practice address
3121 FRUITVALE AVE, OAKLAND, CA 94602-2112
(209) 403-3748
Mailing address
3121 FRUITVALE AVE, OAKLAND, CA 94602-2112
(209) 403-3748
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
08/18/2015
Last updated
12/30/2016
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