Edgewood Suites

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

EDGEWOOD SUITES

Practice address

200 Edmonds Rd
Redwood City, CA 94062-3813

Phone

(650) 367-1980

Fax

(650) 369-6465

NPI assigned

May 13, 2015

Organization subpart

Yes

Parent organization

CORDILLERASAs reported in NPPES

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

Authorized official

Name

Anastasia Burton

Title

Director of Residential Suites

Phone

(650) 367-1890

Specialties & licenses 1

Addresses

Part of

Telecare Soar

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.

• The Cordilleras Corporation

  dba Cordilleras Suite

  • Mental Illness Community Based Residential Treatment Facility
  • Redwood City, CA
  • NPI 1134343262
  NPPES parent name

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1851779615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EDMONDS RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623813",
            "telephone_number": "650-367-1980",
            "fax_number": "650-369-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EDMONDS RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940623813",
            "telephone_number": "650-367-1980",
            "fax_number": "650-369-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD SUITES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORDILLERAS",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "DIRECTOR OF RESIDENTIAL SUITES",
        "authorized_official_telephone_number": "650-367-1890"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marie Eaton, MFT-I
• Mojgan Ebadi, M.D.
• Manuel Victor Ebejer, CATC INTERN
• Meihua Eddy
• Edgewood Center for Children and Families
• Allen D. Efron, MD
• Sarah Margaret Eggen-Thornhill, OTR/L
• Karl Benjamin Ehlert, DC
• Tama Wendy Eichen, LCSW
• Michael Edward Eiffert, MD

• Mental Illness Community Based Residential Treatment Facility in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.