Provider Demographics
NPI:1982977120
Name:LIFE SOULUTIONS
Entity Type:Organization
Organization Name:LIFE SOULUTIONS
Other - Org Name:TRINA SCALF
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALF
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:352-586-3877
Mailing Address - Street 1:209 HAMMOCK RD
Mailing Address - Street 2:
Mailing Address - City:INGLIS
Mailing Address - State:FL
Mailing Address - Zip Code:34449-9542
Mailing Address - Country:US
Mailing Address - Phone:352-586-3877
Mailing Address - Fax:
Practice Address - Street 1:427 NE 3RD ST STE C
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429
Practice Address - Country:US
Practice Address - Phone:352-586-3877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10446251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health