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Miles Rae Lane House
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Novato, California
NPI 1225236953

Miles Rae Lane House is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Novato, CA. Miles Rae Lane House practices in Novato, CA. The NPI Number for Miles Rae Lane House is 1225236953 and holds a License No. 05G790 (California).

The current practice location address for Miles Rae Lane House is 858 Rae Ln, Novato, CA and can be reached out via phone at 415-897-3138.

Location: 858 Rae Ln, Novato, CA, 94947-3941
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1225236953
Provider Name
Miles Rae Lane House
Credential
Provider Entity Type
Organization
Address
858 Rae Ln, Novato, CA, 94947-3941
Phone Number
415-897-3138
Fax Number
Provider Enumeration Date
07/03/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
858 Rae Ln
City
Novato
State
California
Zip
94947-2049
Phone Number
415-897-3138
Fax Number
person
Provider Business Mailing Address Details
Address
858 Rae Ln
City
Novato
State
California
Zip
94947-2049
Phone Number
415-897-3138
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
05G790 (California)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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