# EDGEWOOD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265865240
- **Authorized official:** AUGIE ARBALLO (DIRECTOR, HOSPITAL DIVERSION)
- **Authorized official phone:** (415) 725-0675

## Contact information

- **Practice address:** 1801 VICENTE ST, SAN FRANCISCO, CA 94116-2923
- **Practice address phone:** (909) 215-8288
- **Mailing address:** 1801 VICENTE ST, SAN FRANCISCO, CA 94116-2923

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2013
- **Last updated:** 08/14/2013