| NPI | 1558178665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST L JACKSON Director 415-860-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP1600X Counselor Pastoral | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 207R00000X Internal Medicine | |
| 251B00000X Case Management | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2025-05-16 |