Whalio Doctors

NPI 1225236953

Miles Rae Lane House

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Novato, CA

Practice location

Address
858 Rae Ln, Novato, CA 94947-2049
Phone
(415) 897-3138
Mailing address
1649 Center Rd, Novato, CA 94947-3941

Authorised official

Name
Nancy Dale Lloyd
Title
General Partner
Phone
(415) 897-3138

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320900000X Licence 05G790 (CA)

Registry record

NPI
1225236953
Entity type
Organization
NPI issued
3 Jul 2007
Record last updated
22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.