Provider Demographics
NPI:1134197965
Name:LIFESKILLS PLUS, INC.
Entity type:Organization
Organization Name:LIFESKILLS PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRTLE
Authorized Official - Middle Name:GRAY
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:321-253-9122
Mailing Address - Street 1:1370 SARNO RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5230
Mailing Address - Country:US
Mailing Address - Phone:321-253-9122
Mailing Address - Fax:321-253-9984
Practice Address - Street 1:1370 SARNO RD
Practice Address - Street 2:SUITE C
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5230
Practice Address - Country:US
Practice Address - Phone:321-253-9122
Practice Address - Fax:321-253-9984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health