Provider Demographics
NPI:1215137781
Name:NEW LEAF SERVICES FOR OUR COMMUNITY
Entity type:Organization
Organization Name:NEW LEAF SERVICES FOR OUR COMMUNITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:HARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:415-626-7000
Mailing Address - Street 1:1390 MARKET ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5402
Mailing Address - Country:US
Mailing Address - Phone:415-626-7000
Mailing Address - Fax:
Practice Address - Street 1:103 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-626-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARU88551OtherCBHS CONTRACTING
CA01705103Medicare PIN