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General NPI Number Information
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NPI Number | 1518312529
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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 | 04/27/2016
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 10 LOCKTON LN
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City | NOVATO
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State | CA
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Zip | 94945-2727
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Country | US
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Telephone | 415-891-8000
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Fax | 415-891-8441
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Provider Business Mailing Address
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Address Line | 10 LOCKTON LN
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City | NOVATO
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State | CA
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Zip | 94945-2727
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Country | US
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Telephone | 415-891-8000
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Fax | 415-891-8841
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MS. 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 | 210038BP
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License Number State | CA
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