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Organization

BONITA HOUSE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA EVON WEISSBERGER (EXECUTIVE DIRECTOR)
(105) 931-9505
Entity
Organization

Contact information

Practice address
1410 BONITA AVE, BERKELEY, CA 94709-1909
(510) 526-4765
Mailing address
1919 ADDISON ST STE 204, BERKELEY, CA 94704-1143
(510) 899-7445
(510) 647-9408

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
81492
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
81492
CA
Enumeration date
05/14/2007
Last updated
08/26/2023
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