Healthcare Provider Details

I. General information

NPI: 1952493199
Provider Name (Legal Business Name): HEALTHRIGHT 360
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 HAYES ST
SAN FRANCISCO CA
94117-1128
US

IV. Provider business mailing address

1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US

V. Phone/Fax

Practice location:
  • Phone: 415-750-5111
  • Fax: 415-386-2048
Mailing address:
  • Phone: 415-762-3712
  • Fax: 415-865-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number380020AN
License Number StateCA

VIII. Authorized Official

Name: MS. VITKA EISEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 415-762-1558