Provider Demographics
NPI:1487840930
Name:ACHIEVING LIFESKILLS @ MO LLC
Entity Type:Organization
Organization Name:ACHIEVING LIFESKILLS @ MO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCILE
Authorized Official - Middle Name:
Authorized Official - Last Name:METCALFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-438-3488
Mailing Address - Street 1:19526 FLEET ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-4173
Mailing Address - Country:US
Mailing Address - Phone:660-438-3488
Mailing Address - Fax:
Practice Address - Street 1:19526 FLEET ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355-4173
Practice Address - Country:US
Practice Address - Phone:660-438-3488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services