Organization
MASONIC CENTER FOR YOUTH AND FAMILIES
Active
Parent organization
MASONIC HOMES OF CALIFORNIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
MASONIC HOMES OF CALIFORNIA
Authorized official
SUSANNA BONETTI (ADMINISTRATIVE DIRECTOR)
(415) 929-3001
Entity
Organization
Contact information
Practice address
6 FUNSTON AVE, SAN FRANCISCO, CA 94129
(415) 929-3001
Mailing address
6 FUNSTON AVE, SAN FRANCISCO, CA 94129-1109
(415) 929-3001
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
550001484
CA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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