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General NPI Number Information
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NPI Number | 1265258669
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Entity Type | Organization
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Legal Business Name | LEMONADE RECOVERY HOMES 1
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1371 BUTTE ST
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City | TULARE
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State | CA
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Zip | 93274-7858
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Country | US
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Telephone | 833-939-6159
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Fax |
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Provider Business Mailing Address
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Address Line | 99 ALMADEN BLVD STE 600
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City | SAN JOSE
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State | CA
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Zip | 95113-1605
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Country | US
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Telephone | 833-939-6159
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Fax |
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | GRACE KOZ
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Credential |
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Telephone | 408-898-8791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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