MEDICARE: LIFESKILLS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346321643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESKILLS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 614
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42241-0614
Country	:	US
Telephone Number	:	270-886-2205
Fax Number	:	270-886-0392

Provider Business Practice Location Address
First Line	:	735 NORTH DR
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-2620
Country	:	US
Telephone Number	:	270-886-5163
Fax Number	:	270-886-5178

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	TOMMI HOLLOWAY
Credential	:
Telephone Number	:	270-901-5000

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	09/30/2024

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Directions to “LIFESKILLS, INC. ” Practice Location

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