Provider Demographics
NPI:1740604784
Name:LIFESTYLES MANAGEMENT RESOURCES
Entity Type:Organization
Organization Name:LIFESTYLES MANAGEMENT RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-746-8232
Mailing Address - Street 1:340 EISENHOWER DR
Mailing Address - Street 2:SUITE 1311
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1600
Mailing Address - Country:US
Mailing Address - Phone:954-746-8232
Mailing Address - Fax:954-746-8231
Practice Address - Street 1:340 EISENHOWER DR
Practice Address - Street 2:SUITE 1311
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1600
Practice Address - Country:US
Practice Address - Phone:954-746-8232
Practice Address - Fax:954-746-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder