NPIMap

Organization Active NPI

Homeward Bound of Marin

  • Mental Illness Community Based Residential Treatment Facility
  • San Rafael, CA
National Provider Identifier
1497895189
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
HOMEWARD BOUND OF MARIN
Practice address
830 B St
San Rafael, CA 94901-3003
Phone
(415) 459-5843
Fax
(415) 459-5894
NPI assigned
Feb 8, 2007
Last updated
Jul 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Authorized official

Name
Ms. Mary K Sweeney
Title
Executive Director
Phone
(415) 457-2114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X CA Primary

Addresses

Primary practice location

830 B St
San Rafael, CA 94901-3003

Mailing address

199 Greenfield Ave
San Rafael, CA 94901-2670
Phone (415) 457-2114

Other names 1

  • Voyager Carmel Program Other name

National Provider Directory

National Provider Directory

Locations

199 Greenfield Ave
San Rafael, CA 94901

830 B St
San Rafael, CA 94901
Phone (415) 459-5843

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1497895189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 GREENFIELD AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012670",
            "telephone_number": "415-457-2114",
            "fax_number": "415-457-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 B ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013003",
            "telephone_number": "415-459-5843",
            "fax_number": "415-459-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEWARD BOUND OF MARIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "SWEENEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-457-2114",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Voyager Carmel Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.