1043428998 NPI number — LIFE-SKILLS, INC.

Table of content: (NPI 1043428998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043428998 NPI number — LIFE-SKILLS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFE-SKILLS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043428998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 MORRIS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01570-1812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-949-8080
Provider Business Mailing Address Fax Number:
508-949-6129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
163 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUDLEY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01571-3817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-949-1233
Provider Business Practice Location Address Fax Number:
508-949-6129
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AMICK
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
THOMAS
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
508-949-8080

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1311883 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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