Provider Demographics
NPI:1275908014
Name:LIFE GUIDE SERVICES INC
Entity Type:Organization
Organization Name:LIFE GUIDE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:URIARTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-777-8068
Mailing Address - Street 1:7971 RIVIERA BLVD
Mailing Address - Street 2:SUITE 433
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6445
Mailing Address - Country:US
Mailing Address - Phone:305-777-8068
Mailing Address - Fax:954-800-2290
Practice Address - Street 1:7971 RIVIERA BLVD
Practice Address - Street 2:SUITE 314
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6445
Practice Address - Country:US
Practice Address - Phone:305-777-8068
Practice Address - Fax:954-800-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL002519800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002519800Medicaid
FL017860200Medicaid
FL016921300Medicaid