Provider Demographics
NPI:1154781276
Name:A.K. BEAN FOUNDATION
Entity type:Organization
Organization Name:A.K. BEAN FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-664-7798
Mailing Address - Street 1:623 GREAT JONES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6005
Mailing Address - Country:US
Mailing Address - Phone:707-429-8888
Mailing Address - Fax:707-429-1908
Practice Address - Street 1:623 GREAT JONES ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6005
Practice Address - Country:US
Practice Address - Phone:707-429-8888
Practice Address - Fax:707-429-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)