Organization
NALLS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA DOLLISON (EXECUTIVE DIRECTOR)
(415) 505-6427
Entity
Organization
Contact information
Practice address
1261 TRAVIS BLVD, SUITE 240, FAIRFIELD, CA 94533-4897
(707) 389-4804
Mailing address
PO BOX 460338, SAN FRANCISCO, CA 94146-0338
(415) 505-6427
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
487005267
CA
Other
Enumeration date
03/22/2017
Last updated
03/27/2017
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