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General NPI Number Information
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NPI Number | 1871434886
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Entity Type | Organization
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Legal Business Name | ROOTS OF SACRED LINEAGE II INC
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 9031 BRYCE CANYON LN
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City | BAKERSFIELD
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State | CA
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Zip | 93306-7157
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Country | US
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Telephone | 760-577-5174
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Fax |
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Provider Business Mailing Address
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Address Line | 6083 N FIGARDEN DR UNIT 766
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City | FRESNO
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State | CA
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Zip | 93722-3226
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Country | US
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Telephone | 760-577-5174
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Fax | 760-577-5174
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Authorized Official
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Title or Position | DIRECTOR
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Name | ROBERTA K LAWSON
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Credential | LPT
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Telephone | 760-577-5174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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