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General NPI Number Information
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NPI Number | 1033644984
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Entity Type | Organization
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Legal Business Name | LIFE SKILLS 101, INC.
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 8515 139TH ST
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City | JAMAICA
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State | NY
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Zip | 11435-2637
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Country | US
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Telephone | 718-490-6785
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Fax |
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Provider Business Mailing Address
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Address Line | 8515 139TH ST
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City | JAMAICA
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State | NY
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Zip | 11435-2637
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Country | US
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Telephone | 718-490-6785
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STE BABAKHANOVA
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Credential |
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Telephone | 718-490-6785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 014380
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License Number State | NY
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