Diamond Lodge
NPI #1215119375 in Sf, California
Provider Information
- NPI Number
- 1215119375
- Entity Type
- Organization
- Organization Name
- Diamond Lodge
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Nov 30, 2007
- Last Updated
- Nov 30, 2007
Practice Location
- Address
- 20 ARLINGTON ST
- City
- Sf
- State
- California
- ZIP Code
- 94131
- Phone
- (415) 285-0688
Authorized Official
- Name
- ANNIE MAYO JACOB
- Title
- OWNER ADMINISTRATOR
- Phone
- (415) 577-1004
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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