Provider Demographics
NPI:1215280433
Name:BUILDING OPPORTUNITIES FOR SELF SUFFICIENCY
Entity type:Organization
Organization Name:BUILDING OPPORTUNITIES FOR SELF SUFFICIENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHRS-MENTAL HEALTH RES. COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:510-537-5845
Mailing Address - Street 1:21761 MEEKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3866
Mailing Address - Country:US
Mailing Address - Phone:510-537-5845
Mailing Address - Fax:510-582-2398
Practice Address - Street 1:2065 KITTREDGE ST STE E
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1404
Practice Address - Country:US
Practice Address - Phone:510-649-9130
Practice Address - Fax:510-649-0627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness