Provider Demographics
NPI:1639677842
Name:LOVE AND SERENITY LLC
Entity Type:Organization
Organization Name:LOVE AND SERENITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-821-4423
Mailing Address - Street 1:57 FARALLON CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3726
Mailing Address - Country:US
Mailing Address - Phone:916-821-4423
Mailing Address - Fax:
Practice Address - Street 1:57 FARALLON CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3726
Practice Address - Country:US
Practice Address - Phone:916-821-4423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility