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Healthcare Organization Stored source record

MARIN CENTER FOR INDEPENDENT LIVING

710 4TH ST, SAN RAFAEL, CA, 949013213

atlas:atm_npi_1053005215

Block 1021Block Group 1Census Tract 1110.01Marin CountyCaliforniaUnited States

What is stored

phone
415-459-6245
status
A
address
710 4TH ST, SAN RAFAEL, CA, 949013213
fax
415-459-7047
npi
1053005215
taxonomy
Case Management
other names
[]
last updated
2023-06-08
taxonomy code
251B00000X
all taxonomies
["Case Management"]
enumeration date
2023-06-08
enumeration type
NPI-2
practice locations
0
authorized official
ELISHA GELARDIN
organizational subpart
NO

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{
  "fax": "415-459-7047",
  "npi": "1053005215",
  "phone": "415-459-6245",
  "status": "A",
  "address": "710 4TH ST, SAN RAFAEL, CA, 949013213",
  "license": null,
  "taxonomy": "Case Management",
  "other_names": [],
  "last_updated": "2023-06-08",
  "license_state": null,
  "taxonomy_code": "251B00000X",
  "all_taxonomies": [
    "Case Management"
  ],
  "enumeration_date": "2023-06-08",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "ELISHA GELARDIN",
  "organizational_subpart": "NO"
}