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NPI Code Detail

MEDICARE: LIFE RESOURCE CENTER

MEDICARE: LIFE RESOURCE CENTER
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
1251S00000XCommunity/Behavioral Health Agency040341MI

General Provider Information

NPI Number : 1649393646
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE RESOURCE CENTER
Provider Business Mailing Address
First Line : PO BOX 445
Second Line :
City : LAPEER
State : MI
Zip : 48446-0445
Country : US
Telephone Number : 810-245-3885
Fax Number : 810-667-6459
Provider Business Practice Location Address
First Line : 3533 FORT KNOX DR
Second Line :
City : LAPEER
State : MI
Zip : 48446-2953
Country : US
Telephone Number : 810-245-3885
Fax Number : 810-667-6459
Authorized Official
Title or Position : OWNER
Name : MRS. LORRAINE DALE SIMS
Credential : MA, LLP, LPC
Telephone Number : 810-245-3885
Provider Enumeration Date : 04/06/2007
Last Update Date : 05/15/2008

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Directions to “LIFE RESOURCE CENTER ” Practice Location

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