Provider Demographics
NPI:1518312529
Name:LIVING AT REFLECTIONS, LLC
Entity Type:Organization
Organization Name:LIVING AT REFLECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-891-8000
Mailing Address - Street 1:10 LOCKTON LN
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-2727
Mailing Address - Country:US
Mailing Address - Phone:415-891-8000
Mailing Address - Fax:415-891-8841
Practice Address - Street 1:10 LOCKTON LN
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-2727
Practice Address - Country:US
Practice Address - Phone:415-891-8000
Practice Address - Fax:415-891-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA210038BP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility