MENTAL HEALTH MANAGEMENT I, INC. (NPI# 1881756401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881756401 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH MANAGEMENT I, INC. |
| Other Organization Name | CANYON MANOR |
| Practice Address |
655 Canyon Road Novato CA 94947 |
| Practice Telephone | 4158921628 |
| Practice Fax Number | 4158928624 |
| Mailing Telephone | 4158921628 |
| Mailing Fax Number | 4158928624 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RICHARD PAUL EVATZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4158921628 |
| Authorized Official Credential | L.C.S.W. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 02089023 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Canyon Manor | Doing Business As Name - Organization |
| Street Address |
655 CANYON ROAD |
| City | NOVATO |
| State | CA |
| Zip Code | 94947 |
| 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 |
| 1003995291 | Kim S Frederickson | Dermatology | 400 Professional Center Drive, Suite 414 Novato Dermatology Associates, Novato, CA 94947 | 2006-11-06 |
| Find all providers in zip 94947 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1679172720 | Meadows | Psychiatric Residential Treatment Facility | 6395 Meadows Ct, Malibu, CA 90265-1706 | 2020-10-20 |
| 1912506064 | Point Dume | Psychiatric Residential Treatment Facility | 29149 Cliffside Dr, Malibu, CA 90265-4215 | 2020-10-20 |
| 1275132326 | Beach House | Psychiatric Residential Treatment Facility | 29245 Cliffside Dr, Malibu, CA 90265-4268 | 2020-10-20 |
| 1376159566 | 3855 Brunston LLC | Psychiatric Residential Treatment Facility | 3855 Brunston Ct, Westlake Village, CA 91362-5130 | 2020-09-22 |
| 1649884909 | Montage Recovery Ca LLC | Psychiatric Residential Treatment Facility | 2890 Kana Dume, Malibu, CA 90265 | 2020-09-03 |
| 1245844596 | Montage Recovery California | Psychiatric Residential Treatment Facility | 15367 Valley Vista Blvd, Sherman Oaks, CA 91403 | 2020-09-03 |
| 1063024644 | Crownview Psychiatric Institute | Psychiatric Residential Treatment Facility | 1110 Camino Del Sol Cir, Carlsbad, CA 92008-3509 | 2020-08-17 |
| 1215545652 | Elevation Behavioral Health | Psychiatric Residential Treatment Facility | 3836 Kanan Rd, Agoura Hills, CA 91301-3237 | 2020-07-22 |
| 1053929273 | Montage Recovery Solutions | Psychiatric Residential Treatment Facility | 17801 Twilight Ln, Encino, CA 91316-4330 | 2020-07-14 |
| 1225646441 | Montage Recovery Solutions | Psychiatric Residential Treatment Facility | 2900 S Kanan Dume Rd, Malibu, CA 90265-2792 | 2020-07-14 |
| 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.