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NPI Code Detail

MEDICARE: THE GATHERING INN

MEDICARE: THE GATHERING INN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2251X00000XSupports Brokerage Agency
3385H00000XRespite Care
4251B00000XCase Management Agency

General Provider Information

NPI Number : 1366109704
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GATHERING INN
Provider Business Mailing Address
First Line : 201 BERKELEY AVE
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-2205
Country : US
Telephone Number : 916-791-9355
Fax Number :
Provider Business Practice Location Address
First Line : 201 BERKELEY AVE
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-2205
Country : US
Telephone Number : 916-791-9355
Fax Number : 916-791-1916
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MS. ROLANDE TELLIER
Credential :
Telephone Number : 916-791-9355
Provider Enumeration Date : 11/19/2021
Last Update Date : 07/30/2025

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Directions to “THE GATHERING INN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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