 From its start as a marine hospital in 1798 to its army-based evolution in the 20th century, the Public Health Service District in San Francisco's Presidio National Park has long served patients and pioneered health research and innovation. But after closing in 1981, the site sat vacant and vandalized until Congress established the Presidio Trust in 1996 to preserve the park and its structures. With two landfills, 14 historic buildings and a cemetery beneath a parking lot, revitalizing the district took creativity, perseverance, community support, and substantial investment. The turning point was the public-private alliance between the Presidio Trust and the developer Forest City Enterprise. The trust convened community members, cleared regulatory hurdles, and rehabilitated the structures and landscapes. Forest City led financing and development for the district's centerpiece, the Colonial Revival Style Hospital Building, and relied heavily on federal tax credits for preservation. Today, the district is a gateway to the Presidio and a sustainable mixed-use community. It features housing, office space, a preschool, trails, and 25 acres of open space and native habitat. Rents helped sustain the National Historic Landmark District, and none of it would have worked without Presidio Trust and Forest City's public-private partnership. Together, the partners brought the dynamic historic site back to life, and have ensured another successful chapter in its history.