NPIMap

Organization Active NPI

Lifecircles Group Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Pacoima, CA
National Provider Identifier
1780126870
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
198207474 Issued in CA
Legal business name
LIFECIRCLES GROUP HOME
Practice address
12681 Louvre St
Pacoima, CA 91331-1239
Phone
(818) 256-9451
NPI assigned
Nov 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Mamie Joe Nelson
Title
Program Director
Phone
(818) 834-2463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 198207474 CA Primary

Addresses

Primary practice location

12681 Louvre St
Pacoima, CA 91331-1239

Mailing address

12681 Louvre St
Pacoima, CA 91331-1239
Phone (818) 256-9451

Other names 1

  • Lifecircles Group Home Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1780126870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12681 LOUVRE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311239",
            "telephone_number": "818-256-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12681 LOUVRE ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311239",
            "telephone_number": "818-256-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECIRCLES GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "818-834-2463",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "198207474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifecircles Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pacoima, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.