MEDICARE: LA CHEIM INC.

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
1	251S00000X	Community/Behavioral Health Agency
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	261QM0855X	OTHER	CA	ADOLESCENT, CHILD MS
2	261QM0850X	OTHER	CA	ADULT MENTAL HEALTH
3	322D00000X	OTHER	CA	RESIDENTIAL TREATMENT

General Provider Information

NPI Number	:	1912054701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA CHEIM INC.

Provider Business Mailing Address
First Line	:	1 BOLIVAR DR
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2210
Country	:	US
Telephone Number	:	510-649-1177
Fax Number	:	510-649-0322

Provider Business Practice Location Address
First Line	:	1 BOLIVAR DR
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2210
Country	:	US
Telephone Number	:	510-649-1177
Fax Number	:	510-649-0322

Authorized Official
Title or Position	:	SENIOR DIRECTOR
Name	:	MR. MICHAEL JAMES THOMAS
Credential	:	MSW
Telephone Number	:	510-649-1177

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	09/11/2025

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Directions to “LA CHEIM INC. ” Practice Location

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