Healthcare Provider Details

I. General information

NPI: 1912054701
Provider Name (Legal Business Name): LA CHEIM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BOLIVAR DR
BERKELEY CA
94710-2210
US

IV. Provider business mailing address

1 BOLIVAR DR
BERKELEY CA
94710-2210
US

V. Phone/Fax

Practice location:
  • Phone: 510-649-1177
  • Fax: 510-649-0322
Mailing address:
  • Phone: 510-649-1177
  • Fax: 510-649-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MICHAEL JAMES THOMAS
Title or Position: SENIOR DIRECTOR
Credential: MSW
Phone: 510-649-1177