NPIMap

Organization Active NPI

Cielo House Inc

  • Mental Illness Community Based Residential Treatment Facility
  • San Jose, CA
National Provider Identifier
1235593237
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
CIELO HOUSE INC
Practice address
334 N. Second St.
San Jose, CA 95112
Phone
(408) 834-0616
Fax
(866) 398-5858
NPI assigned
Apr 6, 2016
Organization subpart
Yes
Parent organization
CIELO HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Elliott Richelson, M.D.
Title
President, Treasurer
Phone
(904) 605-4986

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

334 N. Second St.
San Jose, CA 95112

Mailing address

750 El Camino Real
Burlingame, CA 94010
Phone (650) 739-6001

National Provider Directory

National Provider Directory
Tax ID family
Cielo House Inc5 organizations share this tax ID, including this one
Part of
Cielo House Inc

Other organizations with this tax ID 4

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

Locations

334 N 2nd St
San Jose, CA 95112
Phone (408) 454-8208

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1235593237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 EL CAMINO REAL",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "94010",
            "telephone_number": "650-739-6001",
            "fax_number": "866-398-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 N. SECOND ST.",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95112",
            "telephone_number": "408-834-0616",
            "fax_number": "866-398-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIELO HOUSE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CIELO HOUSE INC",
        "enumeration_date": "2016-04-06",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "RICHELSON",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "PRESIDENT, TREASURER",
        "authorized_official_telephone_number": "904-605-4986",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.