Marin Treatment Center

LBN: Marin Treatment Center
Marin Treatment Center is an health care organization with primary practice located at 1466 Lincoln Ave , San Rafael CA 94901-2021. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Methadone, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Methadone is the primary health care specialty. Marin Treatment Center can be contacted via phone (415) 457-3755, or through Fong, Jonathan via phone (415) 457-3755.

Contact Information

Primary practice address
1466 Lincoln Ave San Rafael CA 94901-2021
Phone: (415) 457-3755
Fax: (415) 457-9516
Website:
Map and Directions
Authorized official contact:
Name: Fong, Jonathan MBA
Phone: (415) 457-3755

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Methadone 261QM2800X 21-70 California
Ambulatory Health Care Facilities / Primary Care 261QP2300X 110000417 California

Profile Details

NPI number 1437377421
LBN Legal business name Marin Treatment Center
DBA Doing business as
Authorized official Fong, Jonathan MBA
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2007
Last updated Aug 24th, 2017 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1437377421 NPPES
California MEDICAID ZZR11863F
California MEDICAID CMM70602F
California MEDICAID 00G265381
California MEDICAID EAP70602F

Popular Providers