Basic Information
| Provider Information | |||||||||
| NPI: | 1508226267 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADAPT: A BEHAVIORAL COLLECTIVE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 139 HUGO ST | ||||||||
| Address2: | APT 3 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941222738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106913644 | ||||||||
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| Practice Location | |||||||||
| Address1: | 139 HUGO ST | ||||||||
| Address2: | APT 3 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941222738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106913644 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2016 | ||||||||
| LastUpdateDate: | 07/15/2016 | ||||||||
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| AuthorizedOfficialLastName: | GRANT | ||||||||
| AuthorizedOfficialFirstName: | PHILIP | ||||||||
| AuthorizedOfficialMiddleName: | SANCHEZ | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO/EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3106913644 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | BCBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | N | Agencies | Day Training, Developmentally Disabled Services | 251S00000X | N | Agencies | Community/Behavioral Health | 252Y00000X | Y | Agencies | Early Intervention Provider Agency |
No ID Information.