Provider Demographics
NPI:1215798178
Name:LIFE COACH ON THE GO LLC
Entity type:Organization
Organization Name:LIFE COACH ON THE GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIERRE-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-541-2198
Mailing Address - Street 1:2918 AVENUE I # 1367
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-2935
Mailing Address - Country:US
Mailing Address - Phone:917-946-6378
Mailing Address - Fax:
Practice Address - Street 1:1530 NEW YORK AVE APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2739
Practice Address - Country:US
Practice Address - Phone:844-543-2624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health