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General NPI Number Information
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NPI Number | 1609082700
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Entity Type | Organization
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Legal Business Name | LIFE STEPS FOUNDATION
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 365 E BEACH AVE
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City | INGLEWOOD
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State | CA
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Zip | 90302-3101
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Country | US
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Telephone | 310-673-9915
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Fax | 310-673-0131
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Provider Business Mailing Address
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Address Line | 365 E BEACH AVE
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City | INGLEWOOD
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State | CA
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Zip | 90302-3101
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Country | US
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Telephone | 310-673-9915
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Fax | 310-673-0131
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. CLARENCE CASEY
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Credential |
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Telephone | 310-673-9915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | CA
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