Provider Demographics
NPI:1538377445
Name:ALZHEIMERS SERVICES OF THE EAST BAY INC
Entity type:Organization
Organization Name:ALZHEIMERS SERVICES OF THE EAST BAY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIMSICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-644-3181
Mailing Address - Street 1:2320 CHANNING WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704
Mailing Address - Country:US
Mailing Address - Phone:510-644-3181
Mailing Address - Fax:510-644-8084
Practice Address - Street 1:2320 CHANNING WAY
Practice Address - Street 2:ALZHEIMERS SERVICES OF THE EAST BAY INC - BERKELEY
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704
Practice Address - Country:US
Practice Address - Phone:510-644-3181
Practice Address - Fax:510-644-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000512385H00000X
CA070000506385H00000X
CA070000508385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70056FOtherMEDICAL
CAADU70083HOtherMEDICAL
CAADU70100FOtherMEDICAL