Organization
EDGEWOOD CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN KEITH BENEFIELD (ASSISTANT TREATMENT MANAGER)
(415) 725-0663
Entity
Organization
Contact information
Practice address
1801 VICENTE ST, SAN FRANCISCO, CA 94116-2923
(415) 681-3211
Mailing address
1801 VICENTE ST, SAN FRANCISCO, CA 94116
(415) 681-3211
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/25/2009
Last updated
03/25/2009
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