MEDICARE: DISABLEDCOMMUNITY.ORG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1245647403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISABLEDCOMMUNITY.ORG

Provider Business Mailing Address
First Line	:	2018 23RD AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94116-1215
Country	:	US
Telephone Number	:	415-707-9680
Fax Number	:

Provider Business Practice Location Address
First Line	:	2018 23RD AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94116-1215
Country	:	US
Telephone Number	:	415-707-9680
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LORI GUIDOS
Credential	:	CMT
Telephone Number	:	415-508-6130

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	07/18/2014

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