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General NPI Number Information
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NPI Number | 1003238536
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Entity Type | Organization
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Legal Business Name | LIFE CONCEPTS INC
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 500 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32803-4504
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Country | US
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Telephone | 407-218-4340
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32803-4704
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Country | US
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Telephone | 407-218-4300
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | BROOKE EAKINS
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Credential |
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Telephone | 407-218-4356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0-13-5630
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License Number State | FL
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