Organization
MARINA HARBOR DETOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS A PETRILLO (OWNER)
(978) 788-4460
Entity
Organization
Contact information
Practice address
289 MARINA BLVD, SAN FRANCISCO, CA 94123-1212
(415) 868-3858
Mailing address
289 MARINA BLVD, SAN FRANCISCO, CA 94123-1212
(415) 868-3858
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/18/2019
Last updated
02/07/2024
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