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General NPI Number Information
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NPI Number | 1164203170
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Entity Type | Organization
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Legal Business Name | LIFE BUILDERS, LLC.
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 7413 MAXTOWN RD
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City | WESTERVILLE
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State | OH
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Zip | 43082-9040
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Country | US
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Telephone | 614-305-5156
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Fax |
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Provider Business Mailing Address
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Address Line | 7413 MAXTOWN RD
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City | WESTERVILLE
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State | OH
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Zip | 43082-9040
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Country | US
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Telephone | 614-305-5156
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEEDRA OLNEY
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Credential |
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Telephone | 614-330-5235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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