Mateo Lodge, Inc. in Redwood City - Community Based Residential Treatment Facility, Mental Illness
Mateo Lodge, Inc. - NPI 1447393202
Mateo Lodge, Inc. is a Community Based Residential Treatment Facility, Mental Illness in Redwood City, California. Mateo Lodge, Inc. practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Mateo Lodge, Inc. is 1447393202. The last update date is 2008-06-24.
Mateo Lodge, Inc.'s current location address is 164 Poplar Ave, Redwood City, California. You can contact this provider via phone number 6505689006. The mailing address for Mateo Lodge, Inc. is 164 Poplar Ave, Redwood City, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mateo Lodge, Inc. |
|---|---|
| Address | 164 Poplar Ave, Redwood City, California |
| Phone Number | 6505689006 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Adamson Ian |
| Telephone Number | 6503638125 |
NPI Number Detail
| NPI Number | 1447393202 |
|---|---|
| Provider Enumeration Date | 2007-02-14 |
| Last Updated Date | 2008-06-24 |
Provider Mailing Address Detail
| Address | 164 Poplar Ave |
|---|---|
| City | Redwood City |
| State | California (CA) |
| Post Code | 940613013 |
| Phone Number | 6505689006 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
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Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
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What is the unique identification code assigned to Mateo Lodge, Inc. by the Centers for Medicare & Medicaid Services?
The Mateo Lodge, Inc. has been issued the NPI (National Provider Identifier) 1447393202. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Mateo Lodge, Inc.?
The Mateo Lodge, Inc. is physically situated at 164 Poplar Ave, in the city of Redwood City, state of CA, with the postal code 940613013.
What is the Mateo Lodge, Inc.'s specialty and taxonomy code?
The Mateo Lodge, Inc.'s specialty is Community Based Residential Treatment Facility, Mental Illness, and the corresponding taxonomy code is 320800000X.
When was the Mateo Lodge, Inc.'s 1447393202 issued?
The Mateo Lodge, Inc.'s 1447393202 was issued on 2007-02-14.
When was the Mateo Lodge, Inc.'s information last updated?
The Mateo Lodge, Inc.'s information was last updated on 2008-06-24.