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Organization
INNOVATIVE LIFESKILLS TRAINING CENTER LLC
Active
Organization
INNOVATIVE LIFESKILLS TRAINING CENTER LLC
Active
Other names
Greater Dallas Lifeskills
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL ROBINSON PH.D. (CEO)
(214) 271-0062
Entity
Organization
Contact information
Practice address
5001 SPRING VALLEY, TOWERS EAST STE 400, DALLAS, TX 75244
(214) 448-3753
Mailing address
5001 SPRING VALLEY, TOWERS EAST STE 400, DALLAS, TX 75244-3946
(214) 448-3763
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
7317
TX
305R00000X
Preferred Provider Organization
7317
TX
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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