MEDICARE: LIFE STEPS FOUNDATION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1225363377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE STEPS FOUNDATION, INC.

Provider Business Mailing Address
First Line	:	5839 GREEN VALLEY CIR STE 204
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6963
Country	:	US
Telephone Number	:	310-410-8190
Fax Number	:	310-410-8196

Provider Business Practice Location Address
First Line	:	3450 BROAD ST
Second Line	:	STE 104
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-7214
Country	:	US
Telephone Number	:	805-762-4475
Fax Number	:	805-549-8973

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. VIRGINIA FRANCO
Credential	:
Telephone Number	:	310-410-8190

Provider Enumeration Date	:	10/07/2009
Last Update Date	:	10/07/2009

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