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Organization
BRIDGING THE GAP WITH LIFE SKILLS
Active
Organization
BRIDGING THE GAP WITH LIFE SKILLS
Active
Parent organization
LIFE SKILLS COUNSELING, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE SKILLS COUNSELING, PLLC
Authorized official
MISS TAMMY WORTHINGTON (QUALITY SERVIES DIRECTOR)
(919) 833-2544
Entity
Organization
Contact information
Practice address
2507 BLACKWOLF RUN LN, RALEIGH, NC 27604-5425
(919) 250-9546
(919) 250-7569
Mailing address
204 N PERSON ST, RALEIGH, NC 27601-1047
(919) 833-2544
(919) 833-0939
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL092571
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604129
—
NC
Enumeration date
02/09/2007
Last updated
07/20/2007
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