Organization
BONITA HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA EVON WEISSBERGER (EXECUTIVE DIRECTOR)
(510) 593-1950
Entity
Organization
Contact information
Practice address
1410 BONITA AVE, BERKELEY, CA 94709-1909
(510) 899-7445
(510) 647-9408
Mailing address
2640 MARTIN LUTHER KING JR WAY, BERKELEY, CA 94704-3238
(510) 714-0996
(510) 647-9408
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
CA
320800000X
Mental Illness Community Based Residential Treatment Facility
011400072
CA
Other
Enumeration date
07/25/2006
Last updated
08/02/2024
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