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BAY HORIZON ICF-DDH NPI 1003208281

NPI Profile

NPI: 1003208281
Provider Name: BAY HORIZON ICF-DDH
Classification: Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
516 OCEAN VIEW AVE
SAN MATEO, CA
ZIP 94401
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Phone: (650) 347-1164

BAY HORIZON ICF-DDH is a community based residential treatment facility mental retardation andor developmental disabilities in San Mateo, CA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. BAY HORIZON ICF-DDH NPI is 1003208281. The provider is registered as an organization entity type.

The provider's business location address is:

516 OCEAN VIEW AVE
SAN MATEO, CA
ZIP 94401-029
Phone: (650) 347-1164
Fax: (650) 348-2795

The provider's authorized official is Pureza Aguzar Ganio .
The authorized official title is Ceo and has the following contact phone number (650) 520-5545.

The enumeration date for this NPI number is 2/25/2015 and was last updated on 2/25/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities220000319CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1LTC60671GOTHERCALIFORNIAPROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/5/2020

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