Provider First Line Business Practice Location Address:
1801 VICENTE STREET
Provider Second Line Business Practice Location Address:
THE EDGEWOOD CENTER FOR CHILDREN AND FAMILIES
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94116-2923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-681-3211
Provider Business Practice Location Address Fax Number:
415-664-7094
Provider Enumeration Date:
09/11/2006