Lifehouse Ine

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

LIFEHOUSE INE

Practice address

100 Smith Ranch Rd
Suite 309
San Rafael, CA 94903-1900

Phone

(415) 472-2373

Fax

(415) 472-5739

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Merlyn Teague

Title

Director of Finance/Administration

Phone

(415) 472-2373

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marin Assoc for Retarded Cizen Former legal business name

Tax ID family

Big R Respite Home5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Nova Inc

  • Intellectual Disabilities Intermediate Care Facility
  • San Rafael, CA
  • NPI 1932366895
  NPD tax ID
• Stonehave

  • Intellectual Disabilities Intermediate Care Facility
  • Novato, CA
  • NPI 1770740623
  NPD tax ID
• Sunrise I

  • Intellectual Disabilities Intermediate Care Facility
  • Novato, CA
  • NPI 1891952719
  NPD tax ID
• Sunrise II

  • Intellectual Disabilities Intermediate Care Facility
  • San Rafael, CA
  • NPI 1528225455
  NPD tax ID

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1528240785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SMITH RANCH RD",
            "address_2": "SUITE 309",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031900",
            "telephone_number": "415-472-2373",
            "fax_number": "415-472-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SMITH RANCH RD",
            "address_2": "SUITE 309",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031900",
            "telephone_number": "415-472-2373",
            "fax_number": "415-472-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEHOUSE INE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "MERLYN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE/ADMINISTRATION",
        "authorized_official_telephone_number": "415-472-2373",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMCSUBJ49",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marin Assoc for Retarded Cizen",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Patrick Liang, PMHNP
• Shiri Lichtenstein, PSYD
• Andrew Lie, DVM
• Laurie Laurraine Lieberman, PEER SUPPORT SPECIAL
• John Adrian Liedecke
• Rachel Lim-Vu, M.A.
• Jessie F Lim, PHARM D
• Larisa Limon, HIS
• Ben Lin
• Bertha Bin-San Lin, M.D.

• Intellectual Disabilities Intermediate Care Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.