NPIMap

Organization Active NPI

Cielo House Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Moss Beach, CA
National Provider Identifier
1972967974
Registry record updated Mar 23, 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
323 Cypress Ave
Moss Beach, CA 94038
Phone
(650) 563-9442
Fax
(866) 398-5858
NPI assigned
Apr 6, 2016
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CIELO HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 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
Director, President
Phone
(252) 733-7374

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
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

323 Cypress Ave
Moss Beach, CA 94038

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.

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": "1679529600000",
    "number": "1972967974",
    "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": "323 CYPRESS AVE",
            "city": "MOSS BEACH",
            "state": "CA",
            "postal_code": "94038",
            "telephone_number": "650-563-9442",
            "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": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "RICHELSON",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "DIRECTOR, PRESIDENT",
        "authorized_official_telephone_number": "252-733-7374",
        "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": "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 Moss Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.