Organization Active NPI

Heartwood House LLC

  • Substance Abuse Rehabilitation Facility
  • Novato, CA
National Provider Identifier
1669187555
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
HEARTWOOD HOUSE LLC
Practice address
771 Rowland Blvd
Novato, CA 94947-4647
Phone
(415) 419-8816
Fax
(415) 651-4459
NPI assigned
Jan 16, 2023
Organization subpart
Yes
Parent organization
HEARTWOOD HOUSE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Michael Dempsey
Title
Executive Director
Phone
(415) 867-7143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

771 Rowland Blvd
Novato, CA 94947-4647

Mailing address

8 Circle Rd
San Rafael, CA 94903-3821
Phone (415) 419-8816

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2279178Heartwood House, LLC771 Rowland Blvd, Novato, CA 94947Certificate of waiverMar 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Heartwood House LLC2 organizations share this tax ID, including this one
Part of
Heartwood House LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1669187555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CIRCLE RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033821",
            "telephone_number": "415-419-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 ROWLAND BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474647",
            "telephone_number": "415-419-8816",
            "fax_number": "415-651-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTWOOD HOUSE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTWOOD HOUSE LLC",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "DEMPSEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-867-7143"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.