| Sacred Life Recovery Services | |
|
2681 Lakeshore Blvd Apt 7 Lakeport CA 95453-6971 | |
| (707) 295-2304 | |
| Not Available |
| Full Name | Sacred Life Recovery Services |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2681 Lakeshore Blvd Apt 7, Lakeport, California |
| Authorized Official Name and Position | Raevan Shepherd (COUNSELOR) |
| Authorized Official Contact | 7072952304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Life Recovery Services 495 N Main St Ste 128 Lakeport CA 95453-4809 Ph: (707) 295-2304 | Sacred Life Recovery Services 2681 Lakeshore Blvd Apt 7 Lakeport CA 95453-6971 Ph: (707) 295-2304 |
| NPI Number | 1750119061 |
|---|---|
| Provider Enumeration Date | 07/26/2024 |
| Last Update Date | 09/19/2025 |
| Certification Date | 09/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750119061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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