Provider Demographics
NPI:1255661773
Name:NEW LEAF SERVICES FOR OUR COMMUNITY
Entity Type:Organization
Organization Name:NEW LEAF SERVICES FOR OUR COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL TRAINING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-626-7000
Mailing Address - Street 1:1390 MARKET ST STE 800
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1390 MARKET ST STE 800
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5323
Practice Address - Country:US
Practice Address - Phone:415-626-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health