MEDICARE: LIFE LONG LEARNING CENTER, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	385H00000X	Respite Care	FL
2	347C00000X	Private Vehicle	FL
3	177F00000X	Lodging Provider
4	2278C0205X	Critical Care Certified Respiratory Therapist	FL
5	227800000X	Certified Respiratory Therapist	FL
6	2278E0002X	Emergency Care Certified Respiratory Therapist	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TUC228	OTHER	FL	RESPIRATORY

General Provider Information

NPI Number	:	1649248733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE LONG LEARNING CENTER, INC

Provider Business Mailing Address
First Line	:	1699 SW SOUTHWORTH TER
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34953-1012
Country	:	US
Telephone Number	:	772-340-0594
Fax Number	:	772-340-0594

Provider Business Practice Location Address
First Line	:	1699 SW SOUTHWORTH TER
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34953-1012
Country	:	US
Telephone Number	:	772-340-0594
Fax Number	:	772-304-0594

Authorized Official
Title or Position	:	RESPIRATORY THERAPIST
Name	:	MR. CHARLES HOWARD SWIHART
Credential	:	CRTT
Telephone Number	:	772-340-0594

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	09/11/2025

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Directions to “LIFE LONG LEARNING CENTER, INC ” Practice Location

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