Healthcare Provider Details

I. General information

NPI: 1144658634
Provider Name (Legal Business Name): SIXTH STREET SELF-HELP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 6TH ST
SAN FRANCISCO CA
94103-2829
US

IV. Provider business mailing address

290 TURK ST
SAN FRANCISCO CA
94102-3808
US

V. Phone/Fax

Practice location:
  • Phone: 415-369-3040
  • Fax: 415-546-5260
Mailing address:
  • Phone: 415-749-2100
  • Fax: 415-749-2136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER M COLLINS
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 415-749-2132