Organization · NPI-2

Axis Mundi Center For Mental Health

Clinic/Center, Mental Health (Including Community Mental Health Center) · Oakland, CA

NPI number1396482444
StatusActive
Last updated in NPPESMay 18, 2022

Details

NPI
1396482444
Entity type
Organization (NPI-2)
Legal business name
Axis Mundi Center For Mental Health
Organization subpart
No
Enumeration date
May 18, 2022
Certification date
May 18, 2022
Last updated
May 18, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
261QM0850X Clinic/Center, Adult Mental Health––
261QM0855X Clinic/Center, Adolescent and Children Mental Health––

Practice location

516 Oakland Ave Ste 203
Oakland, CA 94611-5429

Phone 510-838-0249

Mailing address

516 Oakland Ave Ste 203
Oakland, CA 94611-5429

Phone 510-838-0249

Authorized official

Rayne J Banneck
Director Of Hr
5108380249

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