Provider Demographics
NPI:1811129968
Name:CENTER FOR LIFE SKILLS COACHING
Entity type:Organization
Organization Name:CENTER FOR LIFE SKILLS COACHING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-423-3900
Mailing Address - Street 1:23 W SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANDREAS
Mailing Address - State:CA
Mailing Address - Zip Code:95249
Mailing Address - Country:US
Mailing Address - Phone:209-423-3900
Mailing Address - Fax:209-956-2012
Practice Address - Street 1:23 W SAINT CHARLES ST
Practice Address - Street 2:
Practice Address - City:SAN ANDREAS
Practice Address - State:CA
Practice Address - Zip Code:95249
Practice Address - Country:US
Practice Address - Phone:209-423-3900
Practice Address - Fax:209-956-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health