MEDICARE: LEVI LIFE SKILLS LLC

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1902759863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEVI LIFE SKILLS LLC

Provider Business Mailing Address
First Line	:	12658 TIARA ST UNIT 2
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-1023
Country	:	US
Telephone Number	:	747-389-4996
Fax Number	:

Provider Business Practice Location Address
First Line	:	12658 TIARA ST UNIT 2
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-1023
Country	:	US
Telephone Number	:	747-389-4996
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NATHANIEL LEVI
Credential	:
Telephone Number	:	747-389-4996

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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