Provider Demographics
NPI:1558347609
Name:A LIFE COACHING
Entity Type:Organization
Organization Name:A LIFE COACHING
Other - Org Name:A LIFE COACHING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSELIP-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:321-253-5852
Mailing Address - Street 1:1655 ALPHA DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4121
Mailing Address - Country:US
Mailing Address - Phone:321-253-5852
Mailing Address - Fax:
Practice Address - Street 1:1655 ALPHA DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4121
Practice Address - Country:US
Practice Address - Phone:321-253-5852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization