Provider Demographics
NPI:1376846154
Name:LIFE MANAGEMENT CONSULTANTS, INC.
Entity Type:Organization
Organization Name:LIFE MANAGEMENT CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DETKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-843-3677
Mailing Address - Street 1:561 WALLACE RUN RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-5738
Mailing Address - Country:US
Mailing Address - Phone:724-843-3677
Mailing Address - Fax:724-843-8485
Practice Address - Street 1:561 WALLACE RUN RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-5738
Practice Address - Country:US
Practice Address - Phone:724-843-3677
Practice Address - Fax:724-843-8485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA460340103K00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty