Provider Demographics
NPI:1215367057
Name:LIFE STEPS FOUNDATION SOCAL ADULT SERVICES
Entity Type:Organization
Organization Name:LIFE STEPS FOUNDATION SOCAL ADULT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ENGELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-366-7131
Mailing Address - Street 1:500 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2501
Mailing Address - Country:US
Mailing Address - Phone:562-366-7131
Mailing Address - Fax:562-491-6444
Practice Address - Street 1:500 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-2501
Practice Address - Country:US
Practice Address - Phone:562-366-7131
Practice Address - Fax:562-491-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABU20807510251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health