Provider Demographics
NPI:1215218060
Name:ADVANCING LIFE SKILLS, INC.
Entity Type:Organization
Organization Name:ADVANCING LIFE SKILLS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:WOLTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-275-6035
Mailing Address - Street 1:1218 STONE ST.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-275-6035
Mailing Address - Fax:870-275-6249
Practice Address - Street 1:1218 STONE ST.
Practice Address - Street 2:SUITE 110
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-275-6035
Practice Address - Fax:870-275-6249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services