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General NPI Number Information
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NPI Number | 1851694590
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Entity Type | Organization
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Legal Business Name | LIFESKILLS COUNSELING SERVICES
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 290 CONSTITUTION BLVD D
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-5696
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Country | US
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Telephone | 770-722-8156
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Fax | 678-985-3676
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Provider Business Mailing Address
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Address Line | 2990 FORBES TRL
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City | SNELLVILLE
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State | GA
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Zip | 30039-5933
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Country | US
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Telephone | 770-722-8156
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID WILLIAM KUGLIN
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Credential | M.ED
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Telephone | 770-722-8156
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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 | 916
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License Number State | GA
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