MATEO LODGE, INC. (NPI# 1255474920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255474920 |
| Entity Type | Organization |
| Organization Name | MATEO LODGE, INC. |
| Other Organization Name | HUMBOLDT HOUSE |
| Practice Address |
232 S Humboldt St San Mateo CA 94401-2954 |
| Practice Telephone | 6505689006 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | MR. IAN ADAMSON (CEO) |
| Authorized Official Telephone | 6503638125 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 415600236 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Humboldt House | Other Name - Individual/Organization |
| 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 |
| 1740321132 | Mateo Lodge, Inc. | Community Based Residential Treatment Facility, Mental Illness | 420 Cassia St, Redwood City, CA 94063-2011 | 2007-02-09 |
| 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 |
| Street Address |
232 S HUMBOLDT ST |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94401-2954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265964068 | Molly Touse | Counselor | 232 S Humboldt St, San Mateo, CA 94401-2954 | 2017-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800760 | Monica Marie Rivas | Behavior Technician | 429 Peninsula Avenue, San Mateo, CA 94401 | 2020-08-05 |
| 1609412865 | Cindy Toshiko Hedlin | Marriage & Family Therapist | 1117 S. B Street, Suite 9, San Mateo, CA 94401 | 2019-11-22 |
| 1750846655 | James Court Manor Inc. | Assisted Living Facility | 1316 James Court, San Mateo, CA 94401 | 2019-02-05 |
| 1467991778 | Maria Elena Lopez | Student in an Organized Health Care Education/Training Program | 325 Villa Terrace, San Mateo, CA 94401 | 2017-02-20 |
| 1487198339 | Johnie Pangelina | Behavioral Analyst | 242 Peninsula Ave, San Mateo, CA 94401 | 2016-12-12 |
| 1740736230 | Meredith Eileen Morgan | Dentist | 100 S. Ellsworth Av, #601, San Mateo, CA 94401 | 2016-08-25 |
| 1376998963 | Lior Tamir | Dentist | 800 B Street Suite #200, San Mateo, CA 94401 | 2016-05-02 |
| 1609233584 | Delicia Ortega | Behavioral Analyst | 424 Peninsula Avenue, San Mateo, CA 94401 | 2016-01-22 |
| 1396122388 | Ramy Salah | Internal Medicine | 50 S San Mateo Dr Ste 480, San Mateo, CA 94401 | 2015-04-29 |
| 1508255902 | Risso Counseling, Inc. | Marriage & Family Therapist | 120 North El Camino Real, San Mateo, CA 94401 | 2015-01-22 |
| Find all providers in zip 94401 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407118805 | Healthright 360 | Community Based Residential Treatment Facility, Mental Illness | 27 N Humboldt St, Unit A & Unit B, San Mateo, CA 94401-2923 | 2012-06-12 |
| 1932408739 | Caminar | Community Based Residential Treatment Facility, Mental Illness | 1720 S. Amphlett Blvd., Suite 123, San Mateo, CA 94401 | 2011-03-18 |
| 1902035488 | Adult Resource Management Team | Community Based Residential Treatment Facility, Mental Illness | 2000 Alameda De Las Pulgas, 204, San Mateo, CA 94403-1269 | 2009-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
| 1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
| 1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MATEO LODGE, INC..
| 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.