Healthcare Provider Details

I. General information

NPI: 1619007986
Provider Name (Legal Business Name): COMMUNITY FORWARD SF, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 HOWARD ST
SAN FRANCISCO CA
94103-2822
US

IV. Provider business mailing address

1049 HOWARD ST
SAN FRANCISCO CA
94103-2822
US

V. Phone/Fax

Practice location:
  • Phone: 415-487-2140
  • Fax: 415-703-9657
Mailing address:
  • Phone: 415-487-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: FELICIA HOUSTON
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 415-420-1420