Healthcare Provider Details
I. General information
NPI: 1952620171
Provider Name (Legal Business Name): LA CHEIM SCHOOL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2010
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5860 MCBRYDE AVE
RICHMOND CA
94805-1162
US
IV. Provider business mailing address
4892 SAN PABLO DAM RD
EL SOBRANTE CA
94803-3222
US
V. Phone/Fax
- Phone: 510-236-0444
- Fax:
- Phone: 510-243-2360
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 322D00000X |
| Taxonomy | Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
THOMAS
Title or Position: CEO
Credential: MSW, MPA
Phone: 510-222-0292