Provider Demographics
NPI:1942366158
Name:LA CHEIM RESIDENTIAL TREATMENT
Entity Type:Organization
Organization Name:LA CHEIM RESIDENTIAL TREATMENT
Other - Org Name:LA CHEIM, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARRIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-236-0444
Mailing Address - Street 1:5860 MCBRYDE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-1162
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5860 MCBRYDE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-1162
Practice Address - Country:US
Practice Address - Phone:510-236-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children