Organization
LIFESCAPE COMMUNITY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE HUGHES (CHIEF EXECUTIVE OFFICER)
(815) 963-1609
Entity
Organization
Contact information
Practice address
1901 1ST AVE, STERLING, IL 61081-1203
(815) 490-1125
(815) 626-3630
Mailing address
705 KILBURN AVE, ROCKFORD, IL 61101-6550
(815) 963-1609
(815) 963-1627
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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