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General NPI Number Information
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NPI Number | 1689563389
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Entity Type | Organization
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Legal Business Name | PEACEMAKERS LOVE FOUNDATION GOOD CAUSE SACRAMENTO
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 8016 SUNRISE BLVD STE A
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-1603
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Country | US
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Telephone | 916-969-0260
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Fax | 916-993-8580
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Provider Business Mailing Address
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Address Line | 8016 SUNRISE BLVD STE A
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-1603
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Country | US
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Telephone | 916-969-0260
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Fax | 916-993-8580
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MALCOLM A JOHNSON
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Credential |
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Telephone | 916-969-0260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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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 | 310400000X
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Taxonomy Name | Assisted Living 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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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