Healthcare Provider Details

I. General information

NPI: 1790665560
Provider Name (Legal Business Name): ECUMENICAL ASSOCIATION FOR HOUSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PELICAN WAY
SAN RAFAEL CA
94901-5545
US

IV. Provider business mailing address

22 PELICAN WAY
SAN RAFAEL CA
94901-5545
US

V. Phone/Fax

Practice location:
  • Phone: 415-258-1800
  • Fax:
Mailing address:
  • Phone: 415-258-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNA GWYN SIMPSON
Title or Position: VICE PRESIDENT OF RESIDENT SERVICES
Credential:
Phone: 415-720-7492