Basic Information
| Provider Information | |||||||||
| NPI: | 1265070767 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTHRIGHT 360 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1563 MISSION ST FL 4 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941032592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157623700 | ||||||||
| FaxNumber: | 4158650119 | ||||||||
| Practice Location | |||||||||
| Address1: | 1202 MARINER DR | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941301210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157606402 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2019 | ||||||||
| LastUpdateDate: | 12/16/2019 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | DENISE | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT OF COMPLIANCE | ||||||||
| AuthorizedOfficialTelephone: | 4157402311 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/16/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.