Provider Demographics
NPI:1386952422
Name:LEARNING LIFE SKILLS LLC
Entity type:Organization
Organization Name:LEARNING LIFE SKILLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:JAMES-RICKS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:404-786-5989
Mailing Address - Street 1:1710 KENNERSLY CLOSE
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-6728
Mailing Address - Country:US
Mailing Address - Phone:770-491-8551
Mailing Address - Fax:
Practice Address - Street 1:1710 KENNERSLY CLOSE
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-6728
Practice Address - Country:US
Practice Address - Phone:770-491-8551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003667251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health