Provider Demographics
NPI:1457360711
Name:LIFE SOLUTIONS INC.
Entity Type:Organization
Organization Name:LIFE SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-322-7699
Mailing Address - Street 1:6003 W OVERLAND RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-3073
Mailing Address - Country:US
Mailing Address - Phone:208-322-7699
Mailing Address - Fax:208-345-2077
Practice Address - Street 1:6003 W OVERLAND RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3073
Practice Address - Country:US
Practice Address - Phone:208-322-7699
Practice Address - Fax:208-345-2077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW 12321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID=========OtherTAX I.D. NUMBER