Provider Demographics
NPI:1699853739
Name:LIFE SKILLS, INCORPORATED
Entity Type:Organization
Organization Name:LIFE SKILLS, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GILLIAN
Authorized Official - Middle Name:JH
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW, MACRC
Authorized Official - Phone:319-354-2121
Mailing Address - Street 1:483 HIGHWAY 1 W
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4205
Mailing Address - Country:US
Mailing Address - Phone:319-354-2121
Mailing Address - Fax:319-354-0724
Practice Address - Street 1:483 HIGHWAY 1 W
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4205
Practice Address - Country:US
Practice Address - Phone:319-354-2121
Practice Address - Fax:319-354-0724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0089060Medicaid
IA0230839Medicaid