Provider Demographics
NPI:1386703601
Name:LIFE GUIDANCE, LLC
Entity type:Organization
Organization Name:LIFE GUIDANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-435-5334
Mailing Address - Street 1:225 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5323
Mailing Address - Country:US
Mailing Address - Phone:610-435-5334
Mailing Address - Fax:610-419-3446
Practice Address - Street 1:934 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-2567
Practice Address - Country:US
Practice Address - Phone:610-865-1699
Practice Address - Fax:610-419-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA212390261QM0801X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA212390Medicare ID - Type Unspecified
PA212390Medicare ID - Type Unspecified