MILES RAE LANE HOUSE (NPI# 1225236953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225236953 |
| Entity Type | Organization |
| Organization Name | MILES RAE LANE HOUSE |
| Practice Address |
858 Rae Ln Novato CA 94947-2049 |
| Mailing Address |
1649 Center Rd Novato CA 94947-3941 |
| Practice Telephone | 4158973138 |
| Mailing Telephone | 4158973138 |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | NANCY DALE LLOYD (GENERAL PARTNER) |
| Authorized Official Telephone | 4158973138 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 05G790 | CA | Residential Treatment Facilities |
| Street Address |
858 RAE LN |
| City | NOVATO |
| State | CA |
| Zip Code | 94947-2049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407135882 | Rainey Sealey Temkin | Psychologist | 1682 Novato Blvd Ste 105, Novato, CA 94947 | 2011-08-16 |
| 1801192786 | Barbara Jean Gosselin | Marriage & Family Therapist | 1748 Novato Blvd Suite 210, Novato, CA 94947 | 2011-02-10 |
| 1659681377 | Karen Ann Murphy | Occupational Therapist | 27 Stasia Dr., Novato, CA 94947 | 2010-10-15 |
| 1154659415 | Christopher Michael Hackett | Chiropractor | 1559 South Novato Blvd., Suite E, Novato, CA 94947 | 2009-11-25 |
| 1003068305 | Suttinee Saguandeekul | Pharmacist | 910 Diablo Ave, Novato, CA 94947 | 2008-10-17 |
| 1891983581 | Shital Gandhi | Radiology | 500 Redwood Blvd Ste 300, Novato, CA 94947 | 2007-10-09 |
| 1356544126 | Victoria Elizabeth Herzog | Marriage & Family Therapist | 1682 Novato Blvd, Suite 250a, Novato, CA 94947 | 2007-06-07 |
| 1912047655 | Michael Craig Corder | Chiropractor | 1553 S Novato Blvd, A2 Corder Chiropractic Office, Novato, CA 94947 | 2007-02-08 |
| 1427106905 | Jacob Kyle Leone | Naturopath | 1748 Novato Blvd, Suite 100, Novato, CA 94947 | 2007-01-08 |
| 1881756401 | Mental Health Management I, Inc. | Psychiatric Residential Treatment Facility | 655 Canyon Road, Novato, CA 94947 | 2006-12-14 |
| Find all providers in zip 94947 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013115732 | Miles Center Road House | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1649 Center Rd, Novato, CA 94947-3941 | 2007-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589959 | Mcnamar Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2743 Lowell Dr, Chico, CA 95973-7216 | 2020-08-18 |
| 1386277747 | Trilogy Healthcare, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1989 Edgeview Dr, San Jose, CA 95122-4020 | 2020-02-13 |
| 1093257545 | Casa Edithafoundation Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1756 N Hill Ave, Pasadena, CA 91104-1429 | 2016-11-15 |
| 1336696046 | Mj Asset Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 W Merced Ave, West Covina, CA 91790-3904 | 2016-09-10 |
| 1639571599 | New Providence Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5167 G St, Chino, CA 91710-5143 | 2014-09-23 |
| 1427459700 | Good Samaritan Special Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 42612 35th St W, Lancaster, CA 93536-4105 | 2014-09-05 |
| 1699107581 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Dr, Sun Valley, CA 91352-3648 | 2013-08-02 |
| 1790126423 | Contemporary Behavior Consultants, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8032 E Bynum St, Long Beach, CA 90808-3231 | 2013-07-10 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1073868279 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Drive, Sun Valley, CA 91352-3648 | 2012-07-13 |
| 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.