Healthcare Provider Details

I. General information

NPI: 1700920345
Provider Name (Legal Business Name): HEALTHRIGHT 360
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 BUENA VISTA AVE W
SAN FRANCISCO CA
94117-4108
US

IV. Provider business mailing address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

V. Phone/Fax

Practice location:
  • Phone: 415-554-1450
  • Fax: 415-554-1475
Mailing address:
  • Phone: 415-762-3700
  • Fax: 415-865-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number380016ALN
License Number StateCA

VIII. Authorized Official

Name: MS. VITKA EISEN
Title or Position: CEO
Credential: MSW, ED.D
Phone: 415-762-3700