WALLY'S PLACE
NPI 1477695377
Community Based Residential Treatment Facility, Mental Illness in Redwood City, CA
About Wally's Place NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WALLY'S PLACE (NPI 1477695377) is a healthcare organization registered as a community based residential treatment facility, mental illness in Redwood City, California and active in the NPI registry since February 2007. The organization lists Ian Adamson, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mateo Lodge, Inc.'s NPI number?
The NPI number for Mateo Lodge, Inc. is 1477695377. It was assigned to this organization in the NPPES registry on February 14, 2007. The provider is also known as Wally's Place.
Where is Mateo Lodge, Inc. located?
Mateo Lodge, Inc. is located at 695 5th Ave, Redwood City, CA 94063. The listed phone number is (650) 568-9006.
What is Mateo Lodge, Inc.'s specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
When was this NPI record last updated?
The NPPES record for Mateo Lodge, Inc. was last updated on August 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Wally's Place · NPI 1477695377
Community Based Residential Treatment Facility, Mental Illness organization in Redwood City, California. Organization record, active in the CMS NPPES registry since February 14, 2007.
## Identity
- **NPI:** 1477695377 (Entity type: Organization)
- **Enumerated:** February 14, 2007
- **Primary specialty:** Community Based Residential Treatment Facility, Mental Illness · taxonomy 320800000X
- **Legal business name:** Mateo Lodge, Inc.
- **Organization subpart:** Yes (part of Mateo Lodge, Inc.)
- **Authorized official:** Ian Adamson, CEO
## Practice location
- **Address:** 695 5TH AVE, Redwood City, CA 94063-3818
- **Phone:** (650) 568-9006
## Record status
- **NPPES last updated:** August 4, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1477695377) · Data from the CMS NPPES public registry.