LIFEHOUSE INE (NPI# 1528240785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528240785 |
| Entity Type | Organization |
| Organization Name | LIFEHOUSE INE |
| Other Organization Name | MARIN ASSOC FOR RETARDED CIZEN |
| Practice Address |
100 Smith Ranch Rd Suite 309 San Rafael CA 94903-1900 |
| Practice Telephone | 4154722373 |
| Practice Fax Number | 4154725739 |
| Mailing Telephone | 4154722373 |
| Mailing Fax Number | 4154725739 |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |
| Authorized Official Name | MS. MERLYN TEAGUE (DIRECTOR OF FINANCE/ADMINISTRATION) |
| Authorized Official Telephone | 4154722373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CMCSUBJ49 | 05 |
| Other Name | Type Code |
|---|---|
| Marin Assoc for Retarded Cizen | Former Legal Business Name - Organization |
| Street Address |
100 SMITH RANCH RD SUITE 309 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508418583 | Walid Khaled Aljayosi | Pharmacist | 100 Smith Ranch Rd, San Rafael, CA 94903-1900 | 2019-07-10 |
| 1134780208 | Edward Wang | Pharmacist | 100 Smith Ranch Rd, San Rafael, CA 94903-1900 | 2019-06-27 |
| 1518488097 | Shirley Feng | Pharmacist | 100 Smith Ranch Rd, San Rafael, CA 94903-1900 | 2017-07-05 |
| 1386165868 | Sirena Lau | Pharmacist | 100 Smith Ranch Rd, San Rafael, CA 94903-1900 | 2017-07-05 |
| 1013459254 | Ken Mak | Pharmacist | 100 Smith Ranch Rd, San Rafael, CA 94903-1900 | 2016-11-04 |
| 1568828390 | Ali Azarpira | Pharmacist | 100 Smith Ranch Rd, Kaiser Permanente, San Rafael, CA 94903-1900 | 2016-01-09 |
| 1306288790 | Jessica Renae Rucker | Counselor | 100 Smith Ranch Rd, San Rafael, CA 94903-1900 | 2013-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932366895 | Nova Inc | Intermediate Care Facility, Mentally Retarded | 393 Nova Albion Way, San Rafael, CA 94903-3607 | 2008-05-19 |
| 1528225455 | Sunrise II | Intermediate Care Facility, Mentally Retarded | 48 Golden Hinde Blvd, San Rafael, CA 94903-3817 | 2008-05-19 |
| 1528278371 | A Broader Living Experience | Intermediate Care Facility, Mentally Retarded | 25 De Anza Way, San Rafael, CA 94903-3868 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215545538 | Vine Valley Homes II | Intermediate Care Facility, Mentally Retarded | 8400 Bellingham Ave, Sun Valley, CA 91352-3803 | 2020-07-22 |
| 1841811791 | Young Walker Inc. | Intermediate Care Facility, Mentally Retarded | 14 Deer Ct, Sacramento, CA 95823-4402 | 2020-05-01 |
| 1003441155 | Sunrise Premier Homes LLC | Intermediate Care Facility, Mentally Retarded | 13831 Ruther Ave, Paramount, CA 90723-2662 | 2020-03-10 |
| 1649805912 | Jingma Inc | Intermediate Care Facility, Mentally Retarded | 34909 Osprey Dr, Union City, CA 94587-4618 | 2020-03-07 |
| 1124661699 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 581 S Gilmar St, Anaheim, CA 92802-1306 | 2019-10-28 |
| 1467095935 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 1592 W Lorane Way, Anaheim, CA 92802-3930 | 2019-10-28 |
| 1992348460 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 5940 Los Angeles Way, Buena Park, CA 90620-2723 | 2019-10-28 |
| 1578106043 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2918 E Greenhedge Ave, Anaheim, CA 92806-3804 | 2019-10-28 |
| 1790328680 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2143 W Fir Ave, Anaheim, CA 92801-3436 | 2019-10-23 |
| 1356984249 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 6540 Christine Cir, Buena Park, CA 90620-4511 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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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.