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General NPI Number Information
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NPI Number | 1639933872
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Entity Type | Organization
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Legal Business Name | GIFT OF LIFE SOBER LIVING FOUNDATION
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 819 E 82ND ST
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City | LOS ANGELES
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State | CA
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Zip | 90001-3223
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Country | US
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Telephone | 195-199-9127
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Fax |
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Provider Business Mailing Address
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Address Line | 2190 LAVENDER CT
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City | SAN JACINTO
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State | CA
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Zip | 92582-3716
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Country | US
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Telephone | 323-767-6594
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. TIFFANY GREER
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Credential |
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Telephone | 951-999-1277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 174200000X
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Taxonomy Name | Meals Provider
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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 | 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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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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