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LIFE SKILLS VILLAGE PLLC NPI 1629316815


NPI Information

NPI: 1629316815
Provider Name: LIFE SKILLS VILLAGE, PLLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 23D2161530

Address:
25900 GREENFIELD RD
SUITE 100
OAK PARK, MI
ZIP 48237
Phone: (248) 788-4300
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LIFE SKILLS VILLAGE, PLLC is a community behavioral health in Oak Park, MI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. LIFE SKILLS VILLAGE, PLLC NPI is 1629316815. The provider is registered as an organization entity type.

The provider's business location address is:

25900 GREENFIELD RD
SUITE 100
OAK PARK, MI
ZIP 48237-292
Phone: (248) 788-4300
Fax: (248) 605-8099

The provider's authorized official is Nate Gardin .
The authorized official title is Coo and has the following contact phone number (248) 788-4300.

The CLIA number assigned to this NPI record is 23D2161530 - other - outpatient sud facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/22/2013 and was last updated on 2/12/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyNo
2261QR0400XClinic/CenterRehabilitationNo
3251S00000XCommunity/Behavioral HealthD31065MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.