MEDICARE: SENECA CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1558490557
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENECA CENTER

Provider Business Mailing Address
First Line	:	2953 22ND ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3334
Country	:	US
Telephone Number	:	415-206-9921
Fax Number	:

Provider Business Practice Location Address
First Line	:	2953 22ND ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3334
Country	:	US
Telephone Number	:	415-206-9921
Fax Number	:

Authorized Official
Title or Position	:	AWAKE OVERNIGHT COUNSELOR
Name	:	LUIS BELTRAN TREJO
Credential	:
Telephone Number	:	451-206-9921

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	08/22/2020

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Directions to “SENECA CENTER ” Practice Location

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