# LIFE HOUSE REENTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Life House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407732837
- **Authorized official:** MR. JULIUS JACKSON (CEO)
- **Authorized official phone:** (707) 816-0640

## Contact information

- **Practice address:** 2020 HURLEY WAY STE 185D, SACRAMENTO, CA 95825-3223
- **Practice address phone:** (855) 454-3387
- **Mailing address:** 2020 HURLEY WAY STE 185D, SACRAMENTO, CA 95825-3223
- **Mailing address phone:** (855) 454-3387

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |
| 174200000X | Meals Provider | — | NULL | — |
| 177F00000X | Lodging Provider | — | NULL | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |
| 251V00000X | Voluntary or Charitable Agency | — | NULL | — |
| 251X00000X | Supports Brokerage Agency | — | NULL | — |

## Other

- **Enumeration date:** 08/12/2025
- **Last updated:** 12/28/2025