Provider Demographics
NPI:1871682138
Name:LIFE GUIDANCE LLC
Entity Type:Organization
Organization Name:LIFE GUIDANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-865-1699
Mailing Address - Street 1:840 STEFKO BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7079
Mailing Address - Country:US
Mailing Address - Phone:610-865-1699
Mailing Address - Fax:610-865-2812
Practice Address - Street 1:840 STEFKO BLVD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7079
Practice Address - Country:US
Practice Address - Phone:610-865-1699
Practice Address - Fax:610-865-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA212390261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA212390OtherFACILITY LICENCE
PA716867000OtherPROVIDER ID
PA=========OtherTIN