| Huckleberry Youth Programs, Inc | |
|
361 3rd Street Suite G San Rafael CA 94901 | |
| (415) 258-4944 | |
| (415) 258-4943 |
| Full Name | Huckleberry Youth Programs, Inc |
|---|---|
| Speciality | Public Health Or Welfare |
| Location | 361 3rd Street, San Rafael, California |
| Authorized Official Name and Position | Douglas Styles (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4156682622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Huckleberry Youth Programs, Inc 361 3rd Street Suite G San Rafael CA 94901 Ph: (415) 258-4944 | Huckleberry Youth Programs, Inc 361 3rd Street Suite G San Rafael CA 94901 Ph: (415) 258-4944 |
| NPI Number | 1003953100 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 09/16/2022 |
| Certification Date | 09/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003953100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251K00000X | Public Health Or Welfare | (* (Not Available)) | Primary |
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