Provider Demographics
NPI:1639253149
Name:LIFE SKILLS TRAINING CENTER, INC.
Entity Type:Organization
Organization Name:LIFE SKILLS TRAINING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:NORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-546-9554
Mailing Address - Street 1:1510 INDUSTRIAL RD SW
Mailing Address - Street 2:P.O. BOX 1506
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3009
Mailing Address - Country:US
Mailing Address - Phone:712-546-9554
Mailing Address - Fax:712-546-4985
Practice Address - Street 1:1510 INDUSTRIAL RD SW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3009
Practice Address - Country:US
Practice Address - Phone:712-546-9554
Practice Address - Fax:712-546-4985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0744789Medicaid
IA0230201Medicaid
IA0423988Medicaid