Provider Demographics
NPI:1689563389
Name:PEACEMAKERS LOVE FOUNDATION GOOD CAUSE SACRAMENTO
Entity type:Organization
Organization Name:PEACEMAKERS LOVE FOUNDATION GOOD CAUSE SACRAMENTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-969-0260
Mailing Address - Street 1:8016 SUNRISE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-1603
Mailing Address - Country:US
Mailing Address - Phone:916-969-0260
Mailing Address - Fax:916-993-8580
Practice Address - Street 1:8016 SUNRISE BLVD STE A
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-1603
Practice Address - Country:US
Practice Address - Phone:916-969-0260
Practice Address - Fax:916-993-8580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility