Edgewood

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

EDGEWOOD

Practice address

1801 Vicente St
San Francisco, CA 94116-2923

Phone

(909) 215-8288

NPI assigned

Aug 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Augie Arballo

Title

Director, Hospital Diversion

Phone

(415) 725-0675

Specialties & licenses 1

Addresses

Tax ID family

Edgewood2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Edgewood Center for Children and Families

  • Counselor
  • San Francisco, CA
  • NPI 1790131548
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1265865240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "909-215-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "ARBALLO",
        "authorized_official_first_name": "AUGIE",
        "authorized_official_title_or_position": "DIRECTOR, HOSPITAL DIVERSION",
        "authorized_official_telephone_number": "415-725-0675"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Joseph Edevane, SUD COUNSELOR
• Edge Medical Services
• Edge Wood
• Maiya Edgerly
• Lindsay McKinley Edgett, R.N.
• Edgewood
• Edgewood
• Edgewood Center
• Edgewood Center
• Edgewood Center

• Emotionally Disturbed Childrens' Residential Treatment Facility in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.