Organization
FORT HELP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRAMESH PRAKASH SHARMA (SR V P)
(661) 254-6630
Entity
Organization
Contact information
Practice address
915 BRYANT ST, SAN FRANCISCO, CA 94103-4514
(415) 777-9953
(415) 777-4717
Mailing address
26460 SUMMIT CIR, SANTA CLARITA, CA 91350-2991
(661) 254-6630
(661) 254-6644
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
PENDING
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-21
STATE NTP LICENSE
CA
Enumeration date
06/14/2007
Last updated
01/08/2020
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