DIAMOND LODGE (NPI# 1215119375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215119375 |
| Entity Type | Organization |
| Organization Name | DIAMOND LODGE |
| Practice Address |
20 Arlington St Sf CA 94131 |
| Mailing Address |
1135 Tournament Drive Sf CA 94131 |
| Practice Telephone | 4152850688 |
| Mailing Telephone | 4152850688 |
| Mailing Fax Number | 4155506492 |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |
| Authorized Official Name | ANNIE MAYO JACOB (OWNER ADMINISTRATOR) |
| Authorized Official Telephone | 4155771004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | DIAMOND LODGE GUEST RANCH, INC. | Marvin Hatch, 1001 E. Third St., Winslow, AZ 86047 |
| Street Address |
20 ARLINGTON ST |
| City | SF |
| State | CA |
| Zip Code | 94131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851930689 | Lynda Mcpherson | Massage Therapist | 30 Monterey Blvd., San Francisco, CA 94131 | 2019-12-26 |
| 1538695473 | Kylie E Rowe | Physical Therapist | 94 Sussex St, San Francisco, CA 94131 | 2017-05-11 |
| 1609269471 | Kristen Lauters | Behavioral Analyst | 36 A Monterey Blvd, San Francisco, CA 94131 | 2015-03-18 |
| 1780076448 | Michael Smith | Pediatrics | Ucsf Pediatrics, 550 16th St Fl 4, San Francisco, CA 94131 | 2015-03-04 |
| 1205254919 | Sean Kleiman | Behavioral Analyst | 1 Crestline Dr., Unit 1, San Francisco, CA 94131 | 2014-03-31 |
| 1508137167 | Aaron Nystedt | Behavioral Analyst | 36 Monterey Blvd, Suite A, San Francisco, CA 94131 | 2012-01-13 |
| 1841578127 | Amy Lynn Litvin | Registered Nurse | 225 30th St - On Lok Lifeways, 2nd Floor, San Francisco, CA 94131 | 2011-08-03 |
| 1104111020 | Margarite Leah Morch | Marriage & Family Therapist | 18 Whitney Street, San Francisco, CA 94131 | 2011-06-20 |
| 1063744845 | Integrated Pain Care | Preferred Provider Organization | 2 Mercato Court, San Francisco, CA 94131 | 2010-02-04 |
| 1760715031 | Natalie Dominiques Rodrigues | Massage Therapist | 605 Chenery St., Suite C., San Francisco, CA 94131 | 2009-09-17 |
| Find all providers in zip 94131 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508044157 | Pheasant Street Grove Home | Community Based Residential Treatment Facility, Mental Illness | 2056 Grove Street, Sf, CA 94117 | 2008-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
| 1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
| 1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.