BAYSIDE MARIN, LLC (NPI# 1801041074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801041074 |
| Entity Type | Organization |
| Organization Name | BAYSIDE MARIN, LLC |
| Practice Address |
718 4th St San Rafael CA 94901-3213 |
| Practice Telephone | 8007577131 |
| Practice Fax Number | 4154543535 |
| Mailing Telephone | 8007577131 |
| Mailing Fax Number | 4154543535 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |
| Authorized Official Name | MR. TIMOTHY SINNOTT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8007577131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 210021CP | CA | Residential Treatment Facilities |
| Street Address |
718 4TH ST |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-3213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588137434 | Amanda Adams | Nurse Practitioner | 718 4th St, San Rafael, CA 94901-3213 | 2019-01-03 |
| 1417495623 | Bayside Marin, Inc. | Clinic/Center | 718 4th St, San Rafael, CA 94901-3213 | 2017-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982246815 | Ca Ya Services LLC | Substance Abuse Rehabilitation Facility | 285 Margarita Dr, San Rafael, CA 94901-2329 | 2019-10-11 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1295104420 | Robert Bostonian | Substance Abuse Rehabilitation Facility | 67 Grande Paseo, San Rafael, CA 94903-1555 | 2015-09-17 |
| 1982071833 | Brian Finley | Substance Abuse Rehabilitation Facility | 195 Nova Albion Way Apt 21, San Rafael, CA 94903-4528 | 2015-08-26 |
| 1003206228 | Helen Vine Recovery Center | Substance Abuse Rehabilitation Facility | 291 Smith Ranch Rd, San Rafael, CA 94903-5551 | 2015-01-26 |
| 1669716361 | North Bay Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 55 Shaver St, San Rafael, CA 94901-2787 | 2012-11-19 |
| 1316169576 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 39 Mary St, San Rafael, CA 94901-3451 | 2007-05-03 |
| 1235351487 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 519 Belle Ave, San Rafael, CA 94901-3414 | 2007-05-03 |
| 1760601355 | Center Point, Inc. | Substance Abuse Rehabilitation Facility | 812 D St, San Rafael, CA 94901-2814 | 2007-04-24 |
| 1851510440 | Center Point, Inc | Substance Abuse Rehabilitation Facility | 1477 Lincoln Ave, San Rafael, CA 94901-2028 | 2007-04-24 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on BAYSIDE MARIN, LLC.
| 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.