Healthcare Provider Details

I. General information

NPI: 1831498781
Provider Name (Legal Business Name): BAYVIEW HUNTERS POINT FOUNDATION FOR COMMUNITY IMPROVEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 CARROLL AVE
SAN FRANCISCO CA
94124-3219
US

IV. Provider business mailing address

1625 CARROLL AVE
SAN FRANCISCO CA
94124-3219
US

V. Phone/Fax

Practice location:
  • Phone: 415-822-8200
  • Fax: 415-822-6822
Mailing address:
  • Phone: 415-822-8200
  • Fax: 415-822-6822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMES BOUQUIN
Title or Position: CEO
Credential:
Phone: 415-468-5100