# LIFE, A CENTER FOR INDEPENDENT LIVING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LIFE, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760813653
- **Authorized official:** MICHAEL LEFEVOR (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (208) 232-2747

## Contact information

- **Practice address:** 640 PERSHING AVE, 1, POCATELLO, ID 83201-3702
- **Practice address phone:** (208) 232-2747
- **Practice address fax:** (208) 232-2753
- **Mailing address:** 640 PERSHING AVE, 1, POCATELLO, ID 83201-3702
- **Mailing address phone:** (208) 232-2747
- **Mailing address fax:** (208) 232-2753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | M8054374 | ID | Yes |

## Other

- **Enumeration date:** 12/03/2013
- **Last updated:** 05/21/2025