Provider Demographics
NPI: | 1457497141 |
---|---|
Name: | HORIZONS UNLIMITED OF SAN FRANCISCO, INC. |
Entity Type: | Organization |
Organization Name: | HORIZONS UNLIMITED OF SAN FRANCISCO, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NORA |
Authorized Official - Middle Name: | I |
Authorized Official - Last Name: | RIOS REDDICK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 415-487-6717 |
Mailing Address - Street 1: | 440 POTRERO AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN FRANCISCO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94110-1430 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | 415-487-6724 |
Practice Address - Street 1: | 440 POTRERO AVE |
Practice Address - Street 2: | |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94110-1430 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-487-6700 |
Practice Address - Fax: | 415-487-6724 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-29 |
Last Update Date: | 2007-11-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 380059AN | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |