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General NPI Number Information
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NPI Number | 1720272586
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Entity Type | Organization
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Legal Business Name | ADVANCED HYPERBARIC RECOVERY, INC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 1118 IRWIN ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3322
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Country | US
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Telephone | 415-785-8652
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Fax | 415-785-8697
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Provider Business Mailing Address
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Address Line | 1118 IRWIN ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3322
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Country | US
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Telephone | 415-785-8652
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Fax | 415-785-8697
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JANINE MARIE THILL
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Credential | EMT, CHT
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Telephone | 415-785-8652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 200422610009
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License Number State | CA
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