Provider Demographics
NPI:1043019524
Name:MILLBRAE HARMONY HOUSE, LLC
Entity type:Organization
Organization Name:MILLBRAE HARMONY HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAIFUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:SIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-890-6437
Mailing Address - Street 1:675 3RD LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3509
Mailing Address - Country:US
Mailing Address - Phone:408-890-6437
Mailing Address - Fax:
Practice Address - Street 1:192 AVIADOR AVE
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2752
Practice Address - Country:US
Practice Address - Phone:408-890-6437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty