Healthcare Provider Details

I. General information

NPI: 1629251913
Provider Name (Legal Business Name): THE LIFESTYLE & EDUCATION INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 8TH AVE
SACRAMENTO CA
95818-4316
US

IV. Provider business mailing address

2223 8TH AVE
SACRAMENTO CA
95818-4316
US

V. Phone/Fax

Practice location:
  • Phone: 916-752-8983
  • Fax:
Mailing address:
  • Phone: 916-752-8983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. DENNIS M HENNING
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-752-8983