Provider Demographics
NPI:1942834965
Name:LIFE CARE WELLNESS LLC
Entity Type:Organization
Organization Name:LIFE CARE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNY LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDESMA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:702-854-5402
Mailing Address - Street 1:5135 CAMINO AL NORTE STE 259
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2419
Mailing Address - Country:US
Mailing Address - Phone:702-300-5128
Mailing Address - Fax:
Practice Address - Street 1:3465 W CRAIG RD STE D
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5121
Practice Address - Country:US
Practice Address - Phone:702-854-5402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health