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General NPI Number Information
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NPI Number | 1174862064
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Entity Type | Organization
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Legal Business Name | LIVING AT REFLECTIONS LLC
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 1191 SIMMONS LN
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City | NOVATO
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State | CA
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Zip | 94945-1735
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Country | US
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Telephone | 415-891-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1191 SIMMONS LN
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City | NOVATO
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State | CA
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Zip | 94945-1735
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Country | US
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Telephone | 415-891-8000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | DINA YOUNG
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Credential |
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Telephone | 415-891-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 210038AP
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License Number State | CA
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