Organization
ANN MARTIN CENTER
Active
Other names
Madison Park Academy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HASSE LEONARD-PAGEL PHD (DIRECTOR OF CLINICAL PROGRAMS)
(510) 655-7880
Entity
Organization
Contact information
Practice address
470 EL PASEO DR, OAKLAND, CA 94603-3565
(510) 636-7917
Mailing address
1375 55TH ST, EMERYVILLE, CA 94608-2609
(510) 655-7880
(510) 655-3379
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
140000152
CA
Other
Enumeration date
07/08/2010
Last updated
07/21/2022
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