Provider Demographics
NPI:1700959608
Name:CITYWIDE CASE MANAGEMENT
Entity type:Organization
Organization Name:CITYWIDE CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LIESEL
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MFTI
Authorized Official - Phone:415-597-8060
Mailing Address - Street 1:939 MARKET ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1706
Mailing Address - Country:US
Mailing Address - Phone:415-597-8060
Mailing Address - Fax:415-597-8004
Practice Address - Street 1:939 MARKET ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1706
Practice Address - Country:US
Practice Address - Phone:415-597-8060
Practice Address - Fax:415-597-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management