Provider Demographics
NPI:1053084533
Name:LIFE SKILLS DEVELOPMENT LLC
Entity Type:Organization
Organization Name:LIFE SKILLS DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:I/O PSYCHOLOGIST, COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLANE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-225-1577
Mailing Address - Street 1:1655 PALM BEACH LAKES BLVD STE 504
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2206
Mailing Address - Country:US
Mailing Address - Phone:561-255-1577
Mailing Address - Fax:561-255-1577
Practice Address - Street 1:1655 PALM BEACH LAKES BLVD STE 504
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2206
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health