Organization Name: | HOLLY PARK FAMILY HOME |
NPI Number: | 1528253465 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONCHITA RABARA BERRY (ADM AND LICENSEE) |
Mailing Address: | 321 Holly Park Circle San Francisco |
State: | CA US |
Postal Code: | 94110 |
Phone Number: | 4156488292 |
Fax Number: | 4156488292 |
NPI Enumeration Date: | 09/13/2007 |
NPI Last Update Date: | 07/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |