Organization
MATEO LODGE, INC.
Active
Other names
Poplar House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IAN ADAMSON (CEO)
(650) 363-8125
Entity
Organization
Contact information
Practice address
164 POPLAR AVE, REDWOOD CITY, CA 94061-3013
(650) 568-9006
Mailing address
420 CASSIA ST, REDWOOD CITY, CA 94063-2011
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/14/2007
Last updated
06/24/2008
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