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General NPI Number Information
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NPI Number | 1326237785
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Entity Type | Organization
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Legal Business Name | LIFESKILLS, INC.
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 380 SUWANNEE TRAIL ST.
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7956
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Country | US
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Telephone | 270-901-5000
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Fax | 270-842-5268
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Provider Business Mailing Address
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Address Line | 380 SUWANNEE TRAIL ST.
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7956
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Country | US
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Telephone | 270-901-5000
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Fax | 270-842-5268
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Authorized Official
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Title or Position | CEO
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Name | JOE DAN BEAVERS
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Credential |
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Telephone | 270-901-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 800004
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License Number State | KY
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