Provider Demographics
NPI:1912105040
Name:BAYVIEW HUNTERS POINT FOUNDATION FOR COMMUNITY IMPROVEMENT
Entity type:Organization
Organization Name:BAYVIEW HUNTERS POINT FOUNDATION FOR COMMUNITY IMPROVEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:415-468-5100
Mailing Address - Street 1:150 EXECUTIVE PARK BLVD., SUITE 2800
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3303
Mailing Address - Country:US
Mailing Address - Phone:415-468-5100
Mailing Address - Fax:415-468-5104
Practice Address - Street 1:1701 OCEAN AVENUE, SUITE 24
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112
Practice Address - Country:US
Practice Address - Phone:415-452-2202
Practice Address - Fax:415-334-5712
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYVIEW HUNTERS POINT FOUNDATION FOR COMMUNITY IMPROVEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-10
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health