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General NPI Number Information
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NPI Number | 1053576694
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Entity Type | Organization
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Legal Business Name | SALVATION ARMY HARBOR LIGHT CENTER
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 1275 HARRISON STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94103
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Country | US
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Telephone | 415-503-3001
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Fax | 415-861-4261
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Provider Business Mailing Address
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Address Line | 1275 HARRISON STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94103
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Country | US
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Telephone | 415-503-3001
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Fax | 415-861-4261
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICHELLE PIERCE
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Credential |
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Telephone | 415-503-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 380006AN
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License Number State | CA
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