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General NPI Number Information
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NPI Number | 1932256708
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Entity Type | Organization
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Legal Business Name | LIFE LONG LEARNING CENTER INCORPORATED
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 2400 FREDERICK AVE SUITE 108
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-2758
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Country | US
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Telephone | 816-232-2514
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Fax | 816-232-5354
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Provider Business Mailing Address
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Address Line | 2400 FREDERICK AVE SUITE 108
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-2758
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Country | US
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Telephone | 816-232-2514
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Fax | 816-232-5354
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Authorized Official
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Title or Position | PRESIDENT,OWNER
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Name | MS. ADA L SILVY
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Credential | ACSW, LCSW, MSW
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Telephone | 816-232-2514
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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 | 003482
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License Number State | MO
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