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General NPI Number Information
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NPI Number | 1417115718
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Entity Type | Organization
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Legal Business Name | LIFEWORKS INC
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 100 E EUCLID AVE SUITE 151
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City | DES MOINES
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State | IA
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Zip | 50313-4511
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Country | US
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Telephone | 515-255-8399
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Fax | 515-255-8405
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Provider Business Mailing Address
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Address Line | 2213 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5305
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Country | US
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Telephone | 515-237-3974
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Fax | 515-883-2692
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JOHN J STANLEY
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Credential | LISW
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Telephone | 515-255-8399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 04243
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License Number State | IA
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