# LIFE SOLUTIONS OUTPATIENT CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265891543
- **Authorized official:** STAN KOTEI (ADMINISTRATOR)
- **Authorized official phone:** (850) 583-5388

## Contact information

- **Practice address:** 3111 MAHAN DR, SUITE 20 \#113, TALLAHASSEE, FL 32308-5548
- **Practice address phone:** (850) 583-5388
- **Mailing address:** 1341 EAST TENNESSEE STREET, TALLAHASSEE, FL 32308
- **Mailing address phone:** (850) 583-5388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/16/2016
- **Last updated:** 02/16/2016