Provider Demographics
NPI:1851251540
Name:CARLSBAD LIFEHOUSE INC
Entity type:Organization
Organization Name:CARLSBAD LIFEHOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALIN
Authorized Official - Prefix:
Authorized Official - First Name:TIFFINEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-725-5552
Mailing Address - Street 1:PO BOX 3141
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88221-3141
Mailing Address - Country:US
Mailing Address - Phone:575-725-5552
Mailing Address - Fax:575-725-5552
Practice Address - Street 1:500 N KENTUCKY AVE STE 107
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-4721
Practice Address - Country:US
Practice Address - Phone:575-725-5552
Practice Address - Fax:575-725-5552
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLSBAD LIFEHOUSE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty