Organization
IRIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA V GRIMM (PROGRAM DIRECTOR)
(415) 864-2364
Entity
Organization
Contact information
Practice address
12 GOUGH ST, SAN FRANCISCO, CA 94103-1290
(415) 864-0116
Mailing address
12 GOUGH ST, SAN FRANCISCO, CA 94103
(415) 864-0116
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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