Tides Center
Exclusive Provider Organization in San Francisco, CA. Organization (NPI-2).
NPI number1003249657
StatusActive
Last updated in NPPESDec 16, 2016
Details
- NPI
- 1003249657
- Entity type
- Organization (NPI-2)
- Legal business name
- Tides Center
- Organization subpart
- Yes
- Enumeration date
- Aug 19, 2013
- Last updated
- Dec 16, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | – | – | Yes |
Other names
- Adolescent Health Working Group (Other Name)
Practice location
1008 General Kennedy AveSuite R
San Francisco, CA 94129-1729
Phone 415-236-1166
Mailing address
1008 General Kennedy AveSuite R
San Francisco, CA 94129-1729
Phone 415-236-1166
Authorized official
Sarah Rodriguez'G
Executive Director
4152361166
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