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General NPI Number Information
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NPI Number | 1801041074
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Entity Type | Organization
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Legal Business Name | BAYSIDE MARIN, INC.
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 718 4TH ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3213
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Country | US
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Telephone | 800-757-7131
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Fax | 415-454-3535
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Provider Business Mailing Address
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Address Line | 4020 ASPEN GROVE DR STE 900
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City | FRANKLIN
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State | TN
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Zip | 37067-3134
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Country | US
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Telephone | 615-861-6000
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT AND SECRETARY
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Name | MR. BRIAN FARLEY
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Credential |
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Telephone | 615-861-6000
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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 | 210021CP
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License Number State | CA
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