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General NPI Number Information
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NPI Number | 1679778450
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Entity Type | Organization
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Legal Business Name | LIFE MATTERS, INCORPORATED
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3307 NORTHLAKE BLVD SUITE 104
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1703
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Country | US
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Telephone | 561-881-4581
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 BONISLE CIRCLE
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6503
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Country | US
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Telephone | 561-881-4581
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Fax | 561-881-1414
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. SHARON BLACKSHIRE
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Credential | L.C.S.W., C.A.P.
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Telephone | 561-881-4581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW7273
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License Number State | FL
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