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Lifehouse Ine
Intellectual Disabilities Intermediate Care Facility in San Rafael, California
NPI 1528240785

Lifehouse Ine is a Intellectual Disabilities Intermediate Care Facility based in San Rafael, CA. Lifehouse Ine practices in San Rafael, CA. The NPI Number for Lifehouse Ine is 1528240785 and holds a License No. (California).

The current practice location address for Lifehouse Ine is 100 Smith Ranch Rd, San Rafael, CA and can be reached out via phone at 415-472-2373 and via fax at 415-472-5739.

Location: 100 Smith Ranch Rd, San Rafael, CA, 94903-1900
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1528240785
Provider Name
Lifehouse Ine
Credential
Provider Entity Type
Organization
Address
100 Smith Ranch Rd, San Rafael, CA, 94903-1900
Phone Number
415-472-2373
Fax Number
415-472-5739
Provider Enumeration Date
11/29/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
CMCSUBJ49 05 CA
institution
Provider Business Practice Location Address Details
Address
100 Smith Ranch Rd
City
San Rafael
State
California
Zip
94903-1900
Phone Number
415-472-2373
Fax Number
415-472-5739
person
Provider Business Mailing Address Details
Address
100 Smith Ranch Rd
City
San Rafael
State
California
Zip
94903-1900
Phone Number
415-472-2373
Fax Number
415-472-5739
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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