Provider Demographics
NPI:1306546940
Name:COMPLETE LIFE SERVICES LC
Entity type:Organization
Organization Name:COMPLETE LIFE SERVICES LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEON
Authorized Official - Middle Name:F
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, BCD
Authorized Official - Phone:813-943-5323
Mailing Address - Street 1:511 HICKORY HALL LN
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-6348
Mailing Address - Country:US
Mailing Address - Phone:813-943-5323
Mailing Address - Fax:
Practice Address - Street 1:G3500 FLUSHING RD STE 244
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4257
Practice Address - Country:US
Practice Address - Phone:813-943-5323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPLETE LIFE SERVICES PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty