Provider Demographics
NPI:1386179992
Name:LIFE SKILLS RESOURCE CENTER
Entity Type:Organization
Organization Name:LIFE SKILLS RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:EDM
Authorized Official - Phone:908-927-1110
Mailing Address - Street 1:PO BOX 935
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-0935
Mailing Address - Country:US
Mailing Address - Phone:908-927-1110
Mailing Address - Fax:908-927-1113
Practice Address - Street 1:80 LOESER AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-8200
Practice Address - Country:US
Practice Address - Phone:908-927-1110
Practice Address - Fax:908-927-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services