Provider Demographics
NPI:1770862344
Name:SAN MATEO COUNTY
Entity Type:Organization
Organization Name:SAN MATEO COUNTY
Other - Org Name:SERVICE CONNECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-573-2748
Mailing Address - Street 1:550 QUARRY RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-6221
Mailing Address - Country:US
Mailing Address - Phone:650-573-2302
Mailing Address - Fax:650-802-6440
Practice Address - Street 1:550 QUARRY RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-6221
Practice Address - Country:US
Practice Address - Phone:650-573-2302
Practice Address - Fax:650-802-6440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN MATEO COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-12
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health