Provider Demographics
NPI:1861740664
Name:CENTER POINT
Entity type:Organization
Organization Name:CENTER POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:HERING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-526-2942
Mailing Address - Street 1:1601 2ND ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2701
Mailing Address - Country:US
Mailing Address - Phone:415-456-6655
Mailing Address - Fax:
Practice Address - Street 1:135 PAUL DR
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2023
Practice Address - Country:US
Practice Address - Phone:415-446-1924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110000414324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility