West Coast Posttrauma Retreat
Psychiatric Residential Treatment Facility in San Rafael, CA. Organization (NPI-2).
NPI number1891728267
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1891728267
- Entity type
- Organization (NPI-2)
- Legal business name
- West Coast Posttrauma Retreat
- Organization subpart
- No
- Enumeration date
- Jul 9, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 323P00000X | Psychiatric Residential Treatment Facility | Psy 18339 | CA | Yes |
Practice location
4460 - 16 Redwood HwySuite 362
San Rafael, CA 94903-1953
Phone 415-721-9789
Mailing address
4460 - 16 Redwood HwySuite 362
San Rafael, CA 94903-1953
Phone 415-721-9789
Authorized official
Joel Fay
President
4157206653
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