Provider Demographics
NPI:1639580426
Name:LIFE WORKS
Entity Type:Organization
Organization Name:LIFE WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-617-1416
Mailing Address - Street 1:1855 SOUTH ROCK RD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1855 S ROCK RD
Practice Address - Street 2:SUITE 127
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-5113
Practice Address - Country:US
Practice Address - Phone:316-617-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0000000000251C00000X
261QD1600X, 251C00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services