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Organization

HUCKLEBERRY YOUTH PROGRAMS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN QUIGLEY (ASSOCIATE EXECUTIVE DIRECTOR)
(415) 258-4944
Entity
Organization

Contact information

Practice address
361 3RD STREET, SUITE G, SAN RAFAEL, CA 94901
(415) 258-4944
Mailing address
361 3RD STREET, SUITE G, SAN RAFAEL, CA 94901
(415) 258-4944

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
06/23/2010
Last updated
06/23/2010
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