Provider Demographics
NPI:1306321484
Name:LIFEVESTING INTERNATIONAL
Entity type:Organization
Organization Name:LIFEVESTING INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, RPT/S
Authorized Official - Phone:251-206-6600
Mailing Address - Street 1:1120 HILLCREST RD STE 2G
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3955
Mailing Address - Country:US
Mailing Address - Phone:251-206-6600
Mailing Address - Fax:
Practice Address - Street 1:1120 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3968
Practice Address - Country:US
Practice Address - Phone:251-751-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health