Provider Demographics
NPI:1033661152
Name:LIFE APPLIED INC
Entity Type:Organization
Organization Name:LIFE APPLIED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER / CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-540-3491
Mailing Address - Street 1:915 BLANCO CIR # C
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4450
Mailing Address - Country:US
Mailing Address - Phone:831-540-3491
Mailing Address - Fax:
Practice Address - Street 1:915 BLANCO CIR # C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4450
Practice Address - Country:US
Practice Address - Phone:831-540-3491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1153636103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty