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General NPI Number Information
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NPI Number | 1366109704
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Entity Type | Organization
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Legal Business Name | THE GATHERING INN
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Dates
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Enumeration Date | 11/19/2021
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 201 BERKELEY AVE
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City | ROSEVILLE
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State | CA
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Zip | 95678-2205
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Country | US
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Telephone | 916-791-9355
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Fax | 916-791-1916
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Provider Business Mailing Address
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Address Line | 201 BERKELEY AVE
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City | ROSEVILLE
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State | CA
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Zip | 95678-2205
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Country | US
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Telephone | 916-791-9355
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MS. ROLANDE TELLIER
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Credential |
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Telephone | 916-791-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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