Organization
PUWRA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROBERTA MARIE ALLEN (PUBLIC ASSISTANCE COORDINATOR)
(650) 348-6603
Entity
Organization
Contact information
Practice address
1450 CHAPIN AVENUE, SUITE 1, BURLINGAME, CA 94010
(650) 348-6603
(650) 348-0615
Mailing address
1450 CHAPIN AVE, BURLINGAME, CA 94010-4062
(650) 348-6603
(650) 348-0615
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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