Provider Demographics
NPI:1467169698
Name:UNIQUE LIFE SKILLS, LLC
Entity Type:Organization
Organization Name:UNIQUE LIFE SKILLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNHUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-825-3606
Mailing Address - Street 1:13210 N 72ND PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3900
Mailing Address - Country:US
Mailing Address - Phone:845-825-3606
Mailing Address - Fax:
Practice Address - Street 1:2221 N ROSEMONT BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2113
Practice Address - Country:US
Practice Address - Phone:520-323-5534
Practice Address - Fax:520-323-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283Q00000XHospitalsPsychiatric HospitalGroup - Single Specialty
No283X00000XHospitalsRehabilitation Hospital
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility