Organization Active NPI

Marina Harbor Detox

  • Substance Abuse Rehabilitation Facility
  • San Francisco, CA
National Provider Identifier
1720624497
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MARINA HARBOR DETOX
Practice address
289 Marina Blvd
San Francisco, CA 94123-1212
Phone
(415) 868-3858
NPI assigned
Nov 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Colin McBride
Title
Cro
Phone
(631) 672-7441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

289 Marina Blvd
San Francisco, CA 94123-1212

Mailing address

5201 Congress Ave Ste 275
Boca Raton, FL 33487-3609
Phone (415) 868-3858

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://mhd11278.kipuworks.com/ Health Information Exchange (HIE)

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2174998Marina Harbor Detox LLC289 Marina Harbor Blvd, San Francisco, CA 94123Certificate of waiverNov 12, 2027

National Provider Directory

National Provider Directory

Locations

5201 Congress Ave
Ste 275
Boca Raton, FL 33487

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1720624497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 CONGRESS AVE STE 275",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873609",
            "telephone_number": "415-868-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 MARINA BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941231212",
            "telephone_number": "415-868-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA HARBOR DETOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "COLIN",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "631-672-7441"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mhd11278.kipuworks.com/",
            "affiliation": "N",
            "endpointDescription": "HIPPA Comliant EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "289 Marina Blvd",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941231212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.