Diamond Lodge

Organization Active NPI Mental Illness Community Based Residential Treatment Facility · SF, CA

NPI 1215119375 · NPPES record last updated Nov 30, 2007

Key facts

NPI
1215119375
Entity type
Organization (NPI type 2)
Primary specialty
Mental Illness Community Based Residential Treatment Facility 320800000X
Legal business name
DIAMOND LODGE
Practice address
20 Arlington St
SF, CA 94131
Phone
(415) 285-0688
NPI assigned
Nov 30, 2007
Organization subpart
No

Authorized official

Name
Annie Mayo Jacob
Title
Owner Administrator
Phone
(415) 577-1004

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Yes

Addresses

Primary practice location

20 Arlington St
SF, CA 94131

Mailing address

1135 Tournament Drive
SF, CA 94131
Phone (415) 285-0688

Other providers in SF, CA

All providers in SF, CA · Mental Illness Community Based Residential Treatment Facility in California

Sources for this page

Verify at the official NPI Registry.