Organization
HUCKLEBERRY YOUTH PROGRAMS
Active
Parent organization
HUCKLEBERRY YOUTH PROGRAMS
Other names
Nine Grove Lane
Organization subpart
Yes
Provider details
NPI number
Legal business name
HUCKLEBERRY YOUTH PROGRAMS
Authorized official
VIRGINIA PRICE (DIRECTOR OF PROGRAMS AND OPERATIONS)
(415) 668-2622
Entity
Organization
Contact information
Practice address
9 GROVE LN, SAN ANSELMO, CA 94960-2102
(415) 453-5200
(415) 453-8418
Mailing address
9 GROVE LN, SAN ANSELMO, CA 94960-2102
(415) 453-5200
(415) 453-8418
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
210102876
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000021A1C
—
CA
Enumeration date
10/16/2007
Last updated
06/17/2008
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