Provider Demographics
NPI:1225240344
Name:SELF-HELP FOR THE ELDERLY
Entity Type:Organization
Organization Name:SELF-HELP FOR THE ELDERLY
Other - Org Name:ADULT DAY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIARDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-677-7565
Mailing Address - Street 1:408 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3014
Mailing Address - Country:US
Mailing Address - Phone:415-666-7556
Mailing Address - Fax:415-666-1899
Practice Address - Street 1:408 22ND AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-3014
Practice Address - Country:US
Practice Address - Phone:415-666-7556
Practice Address - Fax:415-666-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care