Provider Demographics
NPI:1093296451
Name:LIFESTYLE IMPROVEMENT, LLC
Entity Type:Organization
Organization Name:LIFESTYLE IMPROVEMENT, LLC
Other - Org Name:LIFESTYLE IMPROVEMENT, LLC (OCCUPATIONAL THERAPY)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:877-957-7387
Mailing Address - Street 1:PO BOX 4280
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-4018
Mailing Address - Country:US
Mailing Address - Phone:877-957-7387
Mailing Address - Fax:877-957-7387
Practice Address - Street 1:4411 2ND ST SW
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3726
Practice Address - Country:US
Practice Address - Phone:877-957-7387
Practice Address - Fax:877-957-7387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty