Provider Demographics
NPI:1649900523
Name:ALIGNED LIFE, LLC
Entity type:Organization
Organization Name:ALIGNED LIFE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:EYKELBOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MDIV, LPC
Authorized Official - Phone:808-561-8312
Mailing Address - Street 1:3445 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-1922
Mailing Address - Country:US
Mailing Address - Phone:180-856-1831
Mailing Address - Fax:
Practice Address - Street 1:310 E 6TH ST STE 202
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-5943
Practice Address - Country:US
Practice Address - Phone:808-561-8312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty