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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RON ULRICI (EXECUTIVE DIRECTOR)
(925) 363-5000
Entity
Organization

Contact information

Practice address
535 MARINA BLVD, PITTSBURG, CA 94565-2102
(925) 363-5000
(925) 676-9916
Mailing address
2600 STANWELL DR, SUITE 220, CONCORD, CA 94520-2588
(925) 363-5000

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
070915EN
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070915EN
AOD CERTIFICATION
AR
Enumeration date
05/10/2007
Last updated
06/24/2011
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