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General NPI Number Information
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NPI Number | 1760701486
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Entity Type | Organization
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Legal Business Name | LYRICETE, LLC
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 279 TEDDY AVE APT A
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City | SAN FRANCISCO
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State | CA
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Zip | 94134-2339
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Country | US
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Telephone | 800-695-1106
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Fax | 800-695-1106
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Provider Business Mailing Address
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Address Line | 279 TEDDY AVE APT A
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City | SAN FRANCISCO
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State | CA
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Zip | 94134-2339
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Country | US
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Telephone | 800-695-1106
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Fax | 800-695-1106
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Authorized Official
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Title or Position | CEO
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Name | TIANA DANIELLE BLUNT
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Credential | LVN
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Telephone | 415-410-1985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | VN192915
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | VN192915
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | C5720996
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN192915
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License Number State | CA
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