Organization
EDGEWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGIE ARBALLO (DIRECTOR, HOSPITAL DIVERSION)
(415) 725-0675
Entity
Organization
Contact information
Practice address
1801 VICENTE ST, SAN FRANCISCO, CA 94116-2923
(909) 215-8288
Mailing address
1801 VICENTE ST, SAN FRANCISCO, CA 94116-2923
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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