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General NPI Number Information
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NPI Number | 1184128571
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Entity Type | Organization
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Legal Business Name | LEARNING INSTITUTE FOR FUNCTIONAL EDUCATION (L.I.F.E.)
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1620 N CARPENTER RD STE C19
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City | MODESTO
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State | CA
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Zip | 95351-1156
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Country | US
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Telephone | 209-900-3722
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Fax | 209-859-9005
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Provider Business Mailing Address
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Address Line | 1620 N CARPENTER RD STE C19
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City | MODESTO
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State | CA
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Zip | 95351-1156
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Country | US
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Telephone | 209-900-3722
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Fax | 209-859-9005
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Authorized Official
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Title or Position | CEO
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Name | MISS TERRA DAWN OEHLER
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Credential | BCBA
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Telephone | 209-900-3722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | CA
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