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Organization

BUILDING OPPORTUNITIES FOR SELF-SUFFICIENCY

Active
Other names
BOSS Shelter Network MAA
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD IVY FRAZIER (EXECUTIVE DIRECTOR)
(510) 649-1935
Entity
Organization

Contact information

Practice address
258 W A ST, HAYWARD, CA 94541-4850
(510) 732-5956
(510) 732-5954
Mailing address
1918 UNIVERSITY AVE STE 2A, BERKELEY, CA 94704-3263
(510) 649-1930
(510) 649-0627

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8134
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
05/25/2007
Last updated
01/02/2019
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