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General NPI Number Information
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NPI Number | 1982977120
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Entity Type | Organization
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Legal Business Name | LIFE SOULUTIONS
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 427 NE 3RD ST STE C
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429
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Country | US
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Telephone | 352-586-3877
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Fax |
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Provider Business Mailing Address
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Address Line | 209 HAMMOCK RD
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City | INGLIS
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State | FL
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Zip | 34449-9542
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Country | US
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Telephone | 352-586-3877
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | TRINA SCALF
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Credential | M.A.
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Telephone | 352-586-3877
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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 | MH10446
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License Number State | FL
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