Healthcare Provider Details
I. General information
NPI: 1699462655
Provider Name (Legal Business Name): HEALTHRIGHT 360
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2023
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1076 HOWARD ST
SAN FRANCISCO CA
94103-2820
US
IV. Provider business mailing address
1563 MISSION ST FL 4
SAN FRANCISCO CA
94103-2592
US
V. Phone/Fax
- Phone: 415-762-3700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ATHILA
LAMBINO
Title or Position: DIRECTOR OF LICENSING & CERT
Credential:
Phone: 415-912-0605