Healthcare Provider Details
I. General information
NPI: 1902948532
Provider Name (Legal Business Name): HEALTHRIGHT 360
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
214 HAIGHT ST
SAN FRANCISCO CA
94102-6127
US
IV. Provider business mailing address
1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US
V. Phone/Fax
- Phone: 415-554-1480
- Fax:
- Phone: 415-762-3700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | 380016AHN |
| License Number State | CA |
VIII. Authorized Official
Name: MS.
VITKA
EISEN
Title or Position: CEO
Credential: MSW, ED.D
Phone: 415-762-3700