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General NPI Number Information
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NPI Number | 1760208409
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Entity Type | Organization
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Legal Business Name | FATHERS TO FOUNDERS
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1188 MISSION ST APT 517
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-1593
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Country | US
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Telephone | 510-343-1934
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Fax |
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Provider Business Mailing Address
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Address Line | 1188 MISSION ST APT 517
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-1593
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Country | US
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Telephone | 510-343-1934
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ELGIN LYNIERE ROSE SR.
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Credential |
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Telephone | 510-343-1934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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