Provider Demographics
NPI:1154707149
Name:LIFESCAPE
Entity type:Organization
Organization Name:LIFESCAPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-444-9515
Mailing Address - Street 1:4100 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6620
Mailing Address - Country:US
Mailing Address - Phone:605-444-9900
Mailing Address - Fax:605-444-9901
Practice Address - Street 1:4100 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6620
Practice Address - Country:US
Practice Address - Phone:605-444-9900
Practice Address - Fax:605-444-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management