Provider Demographics
NPI:1265916696
Name:CITY & COUNTY OF SAN FRANCISCO
Entity type:Organization
Organization Name:CITY & COUNTY OF SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHONA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAUTISTA-PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-255-3706
Mailing Address - Street 1:555 POLK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3333
Mailing Address - Country:US
Mailing Address - Phone:415-202-2810
Mailing Address - Fax:
Practice Address - Street 1:555 POLK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3333
Practice Address - Country:US
Practice Address - Phone:415-202-2810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY & COUNTY OF SAN FRANCISCO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children