Provider Demographics
NPI:1982781159
Name:BAART COMMUNITY HEALTHCARE
Entity type:Organization
Organization Name:BAART COMMUNITY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JARVIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-379-3300
Mailing Address - Street 1:1720 LAKEPOINTE DR STE 117
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6425
Mailing Address - Country:US
Mailing Address - Phone:214-369-3300
Mailing Address - Fax:214-853-9018
Practice Address - Street 1:1111 MARKET ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1513
Practice Address - Country:US
Practice Address - Phone:415-552-7914
Practice Address - Fax:415-552-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QC1500X, 261QM0850X
NC261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G628740Medicaid
CA00A433511Medicaid
CACMM70931FMedicaid
CACMM7115FMedicaid
CACMM70933FMedicaid
CACMM70932FMedicaid
CA00A418610Medicaid
CA00G459400Medicaid
CACMM70951FMedicaid
CACMM70950FMedicaid
CAW15735Medicare PIN
CA00A418610Medicaid
CACMM70933FMedicaid
CACMM70931FMedicaid