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General NPI Number Information
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NPI Number | 1275623803
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Entity Type | Organization
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Legal Business Name | LA CHEIM SCHOOL INC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 13201 SAN PABLO AVE SUITE # 303
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City | SAN PABLO
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State | CA
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Zip | 94806-3952
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Country | US
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Telephone | 510-231-2300
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Fax | 510-237-6468
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Provider Business Mailing Address
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Address Line | 2853 GROOM DR
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City | RICHMOND
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State | CA
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Zip | 94806-2664
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Country | US
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Telephone | 510-223-4393
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Fax | 510-262-1502
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL J THOMAS
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Credential | MA
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Telephone | 510-222-0292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 140000663
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License Number State | CA
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