Miles Center Road House

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

55G139 Issued in CA

Legal business name

MILES CENTER ROAD HOUSE

Practice address

1649 Center Rd
Novato, CA 94947-3941

Phone

(415) 897-3138

NPI assigned

Jul 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nancy Dale Lloyd

Title

General Partner

Phone

(415) 897-3138

Specialties & licenses 1

Addresses

Tax ID family

Miles Center Road House2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Miles Rae Lane House

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Novato, CA
  • NPI 1225236953
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013115732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 CENTER RD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473941",
            "telephone_number": "415-897-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 CENTER RD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473941",
            "telephone_number": "415-897-3138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILES CENTER ROAD HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "415-897-3138"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "55G139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joni Metolius, MFT
• MG Healing Wheels Transportation LLC
• Michael L Rosenthal DDS & Rajiv J Anand DDS Inc
• Hannah Rachel Michahelles
• Michelle Shariat-Hansen
• Miles Rae Lane House
• Aleyah Swan Miller
• Mobile Wound & Diagnostics Inc
• Amir Momenzadeh
• Monarch Chiropractic

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Novato, CA
• Providers in Novato, CA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.