MATEO LODGE, INC.


Address: 420 Cassia St, Redwood City, CA 94063-2011
Phone: 6503638125

MATEO LODGE, INC. (NPI# 1740321132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740321132
Entity Type Organization
Organization Name MATEO LODGE, INC.
Other Organization Name CASSIA HOUSE
Practice Address 420 Cassia St
Redwood City
CA 94063-2011
Practice Telephone 6503638125
Enumeration Date 2007-02-09
Last Update Date 2008-06-24
Authorized Official Name MR. IAN ADAMSON (CEO)
Authorized Official Telephone 6503638125
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness 410507269 CA Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Cassia House Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1447393202 Mateo Lodge, Inc. Community Based Residential Treatment Facility, Mental Illness 164 Poplar Ave, Redwood City, CA 94061-3013 2007-02-14
1255474920 Mateo Lodge, Inc. Community Based Residential Treatment Facility, Mental Illness 232 S Humboldt St, San Mateo, CA 94401-2954 2007-02-14
1477695377 Mateo Lodge, Inc. Community Based Residential Treatment Facility, Mental Illness 695 5th Ave, Redwood City, CA 94063-3818 2007-02-14
1851445423 Mateo Lodge, Inc. Community/Behavioral Health 695 5th Ave, Redwood City, CA 94063-3818 2007-01-22

Office Location

Street Address 420 CASSIA ST
City REDWOOD CITY
State CA
Zip Code 94063-2011

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659905933 Kris Eryk Bartolome Case Manager/Care Coordinator 420 Cassia St, Redwood City, CA 94063-2011 2020-02-26
1790340909 Faith Arca Community Health Worker 420 Cassia St, Redwood City, CA 94063-2011 2019-05-02
1366924946 Patricia Sandoval Community Health Worker 420 Cassia St, Redwood City, CA 94063-2011 2018-08-30
1386133692 Austin Paul Matthew Cuellar Community Health Worker 420 Cassia St, Redwood City, CA 94063-2011 2018-05-02
1114453354 Nicole Brown Counselor 420 Cassia St, Redwood City, CA 94063-2011 2017-05-09
1477892735 Everett Touse Counselor 420 Cassia St, Redwood City, CA 94063-2011 2013-02-06
1124259908 Francisco Yapan Alagbate Counselor 420 Cassia St, Redwood City, CA 94063-2011 2009-07-28
1013182096 Denby Glenn Adamson Counselor 420 Cassia St, Redwood City, CA 94063-2011 2008-04-29
1952507386 Brian L Reed Counselor 420 Cassia St, Redwood City, CA 94063-2011 2007-06-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578104378 Jade Francetich Psychologist 450 Broadway St., Pavilion B 2nd Floor, Redwood City, CA 94063 2019-10-02
1861052060 County of San Mateo Clinic/Center 1300 Maple St., Redwood City, CA 94063 2019-06-19
1750941977 County of San Mateo Clinic/Center 300 Bradford St., Redwood City, CA 94063 2019-06-19
1023678661 Linda K Watanabe Preventive Medicine 700 Bay Rd. #2803, Redwood City, CA 94063 2019-06-17
1235630369 Waverly Place Apartments, Lp Case Management 105 Waverly Place, Redwood City, CA 94063 2018-02-23
1306371679 Caely Alise Hambro Student in an Organized Health Care Education/Training Program Stanford Dermatology, 430 Broadway, Redwood City, CA 94063 2017-04-25
1609316736 Justine Nicole Dela Cruz Nurse Practitioner 420 Broadway St # D, Redwood City, CA 94063 2017-03-08
1336683234 Babita Chopra Pharmacist 2300 Middlefield Road, Redwood City, CA 94063 2016-12-12
1073065595 Diana Genoveva Posner I Counselor 604 Prince Ave. Ste A, Redwood City, CA 94063 2016-11-01
1295288264 Benjamin Dickter Student in an Organized Health Care Education/Training Program 1107 2nd Ave, Apt 103, Redwood City, CA 94063 2016-07-26
Find all providers in zip 94063

Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023556255 Amanda Johnson Community Based Residential Treatment Facility, Mental Illness 1442 Valota Rd, Redwood City, CA 94061-2620 2017-02-08
1447393202 Mateo Lodge, Inc. Community Based Residential Treatment Facility, Mental Illness 164 Poplar Ave, Redwood City, CA 94061-3013 2007-02-14
1063509123 Cordilleras Mental Health Corporation Community Based Residential Treatment Facility, Mental Illness 200 Edmonds Rd, Redwood City, CA 94062-3813 2006-10-09
1043860760 Tyler Reese Turner Harvey Community Based Residential Treatment Facility, Mental Illness 248 Redwood Ave, Redwood City, CA 94061 2019-09-14
1851779615 Edgewood Suites Community Based Residential Treatment Facility, Mental Illness 200 Edmonds Rd, Redwood City, CA 94062-3813 2015-05-13
1982033486 Telecare Corporation Community Based Residential Treatment Facility, Mental Illness 200 Edmonds Rd, Redwood City, CA 94062-3813 2013-11-05
1497085138 Canyon Oaks Youth Center Community Based Residential Treatment Facility, Mental Illness 400 Edmonds Rd, Redwood City, CA 94062-3803 2009-12-31
1619155942 San Mateo County Community Based Residential Treatment Facility, Mental Illness 400 Edmonds Rd, Redwood City, CA 94062-3803 2008-02-08
1134343262 The Cordilleras Corporation Community Based Residential Treatment Facility, Mental Illness 200 Edmonds Rd, Redwood City, CA 94062-3813 2007-04-12
1477695377 Mateo Lodge, Inc. Community Based Residential Treatment Facility, Mental Illness 695 5th Ave, Redwood City, CA 94063-3818 2007-02-14
Find all providers in REDWOOD CITY

Competitor

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City REDWOOD CITY
Zip Code 94063

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Dataset Information

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.

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