Provider Demographics
NPI:1134642614
Name:LIFE SKILLS EMPOWERMENT CENTER
Entity Type:Organization
Organization Name:LIFE SKILLS EMPOWERMENT CENTER
Other - Org Name:CHILDRENS HAVEN OF HOPE FOOD BANK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:MADISON
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER OF ARTS
Authorized Official - Phone:720-300-7641
Mailing Address - Street 1:171 DEL MAR CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8217
Mailing Address - Country:US
Mailing Address - Phone:720-300-7641
Mailing Address - Fax:303-699-0827
Practice Address - Street 1:171 DEL MAR CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8217
Practice Address - Country:US
Practice Address - Phone:720-300-7641
Practice Address - Fax:303-699-0827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities