Provider Demographics
NPI:1699067421
Name:OPTIONS RECOVERY CONNECTIONS PROGRAM
Entity type:Organization
Organization Name:OPTIONS RECOVERY CONNECTIONS PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-836-9900
Mailing Address - Street 1:610 16TH ST STE 315
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1284
Mailing Address - Country:US
Mailing Address - Phone:510-836-9900
Mailing Address - Fax:510-836-9902
Practice Address - Street 1:610 16TH ST STE 315
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1284
Practice Address - Country:US
Practice Address - Phone:510-836-9900
Practice Address - Fax:510-836-9902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIONS RECOVERY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management