=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730514522
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOOLS FOR LIFE, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2013
-----------------------------------------------------
Last Update Date | 09/11/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 S STOLP AVE
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60506-5142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-906-1200
-----------------------------------------------------
Fax | 630-906-1203
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35 S STOLP AVE
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60506-5142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-906-1200
-----------------------------------------------------
Fax | 630-906-1203
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. MICHELLE SIMMONS-FIORITO
-----------------------------------------------------
Credential | BS CADC
-----------------------------------------------------
Telephone | 630-906-1200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | A-1925-0003-A
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------