# LIFECIRCLES GROUP HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifecircles Group Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780126870
- **Authorized official:** MS. MAMIE JOE NELSON (PROGRAM DIRECTOR)
- **Authorized official phone:** (818) 834-2463

## Contact information

- **Practice address:** 12681 LOUVRE ST, PACOIMA, CA 91331-1239
- **Practice address phone:** (818) 256-9451
- **Mailing address:** 12681 LOUVRE ST, PACOIMA, CA 91331-1239
- **Mailing address phone:** (818) 256-9451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 198207474 | CA | Yes |

## Other

- **Enumeration date:** 11/07/2016
- **Last updated:** 03/15/2017