Organization
INTEGRATED CARE CENTER
Active
Parent organization
HAIGHT ASHBURY FREE CLINICS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAIGHT ASHBURY FREE CLINICS, INC
Authorized official
JOEY CAIN (ADMINISRTATIVE ASSISTANT)
(415) 746-1967
Entity
Organization
Contact information
Practice address
1735 MISSION ST, SAN FRANCISCO, CA 94103-2417
(415) 746-1940
(415) 746-1941
Mailing address
1735 MISSION ST, SAN FRANCISCO, CA 94103-2417
(415) 746-1940
(415) 746-1941
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
550000486
CA
261QR0400X
Rehabilitation Clinic/Center
Primary
380016ACN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
380016ACN
DADP CERTIFICATION
CA
01
—
550000486
LICENSE
CA
05
—
CMM71176F
—
CA
Enumeration date
07/03/2007
Last updated
04/16/2008
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