Community Life Skills Agency

Organization Active NPI Homemaker · Newark, CA

NPI 1669987145 · NPPES record last updated Dec 6, 2017

Key facts

NPI
1669987145
Entity type
Organization (NPI type 2)
Primary specialty
Homemaker 376J00000X
License
C3922881 (CA)
Legal business name
COMMUNITY LIFE SKILLS AGENCY
Practice address
5920 Thornton Ave Ste C
Newark, CA 94560-3843
Phone
(800) 398-9141
Fax
(510) 745-0105
NPI assigned
Dec 6, 2017
Organization subpart
No

Authorized official

Name
Diana Carol Hansson, BACHELOR OF SCIENCE
Title
Ceo/Program Director
Phone
(800) 398-9141

National Provider Directory

Locations

5920 Thornton Ave
Ste C
Newark, CA 94560
Phone (800) 398-9141

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker
Group: 193400000X SINGLE SPECIALTY GROUP
376J00000X C3922881 CA Yes

Addresses

Primary practice location

5920 Thornton Ave Ste C
Newark, CA 94560-3843

Mailing address

5920 Thornton Ave Ste C
Newark, CA 94560-3843
Phone (800) 398-9141

Other providers in Newark, CA

All providers in Newark, CA · Homemaker in California

Sources for this page

Verify at the official NPI Registry.