Organization
LIFE IDEALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BURKE LANE LCSW (OWNER)
(207) 333-3507
Entity
Organization
Contact information
Practice address
178 LISBON ST, 3RD FLOOR, LEWISTON, ME 04240-7234
(207) 333-3507
Mailing address
178 LISBON ST, 3RD FLOOR, LEWISTON, ME 04240-7234
(207) 333-3507
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10597
ME
1041C0700X
Clinical Social Worker
LC8317
ME
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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