Wally'S Place

LBN: Mateo Lodge, Inc.
Wally'S Place is an health care organization with primary practice located at 695 5Th Ave , Redwood City CA 94063-3818. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. Mateo Lodge, Inc. can be contacted via phone (650) 568-9006, or through Adamson, Ian via phone (650) 363-8125.

Contact Information

Primary practice address
695 5Th Ave Redwood City CA 94063-3818
Phone: (650) 568-9006
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Adamson, Ian
Phone: (650) 363-8125

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X 410508908 California

Profile Details

NPI number 1477695377
LBN Legal business name Mateo Lodge, Inc.
DBA Doing business as Wally'S Place
Authorized official Adamson, Ian
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 14th, 2007
Last updated Aug 4th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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