Healthcare Provider Details

I. General information

NPI: 1780719344
Provider Name (Legal Business Name): SENECA CENTER CTF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

IV. Provider business mailing address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-6467
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE SIEGEL
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 415-206-4228