Provider Demographics
NPI:1891174363
Name:LIFESTYLE EDUCATION & AWARENESS PROGRAM
Entity Type:Organization
Organization Name:LIFESTYLE EDUCATION & AWARENESS PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-944-4701
Mailing Address - Street 1:565 S MASON RD
Mailing Address - Street 2:#453
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2437
Mailing Address - Country:US
Mailing Address - Phone:281-944-4701
Mailing Address - Fax:888-789-4755
Practice Address - Street 1:2212 PRIMROSE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4157
Practice Address - Country:US
Practice Address - Phone:210-296-6733
Practice Address - Fax:888-789-4755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)