Organization
KINGDOM BUILDERS TRANSITIONAL HOUSING PROGRAM
Active
Other names
Kingdom Builders Transitional Housing
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST L JACKSON DMIN (DIRECTOR)
(415) 860-6767
Entity
Organization
Contact information
Practice address
2321 INTERNATIONAL BLVD, OAKLAND, CA 94601-1018
(510) 326-2446
Mailing address
2321 INTERNATIONAL BLVD, OAKLAND, CA 94601-1018
(510) 326-2446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
207R00000X
Internal Medicine Physician
—
—
251B00000X
Case Management Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
311ZA0620X
Adult Care Home Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
05/16/2025
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