Organization
LIFEWORKS SUBSTANCE ABUSE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RHOADIE LADD (CEO)
(941) 979-5023
Entity
Organization
Contact information
Practice address
4678 TAMIAMI TRL, #105, PORT CHARLOTTE, FL 33980-2900
(941) 979-5023
(941) 979-5064
Mailing address
4678 TAMIAMI TRL, #105, PORT CHARLOTTE, FL 33980-2900
(941) 979-5023
(941) 979-5064
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8565
FL
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH8565
STATE OF FLORIDA
FL
Enumeration date
09/16/2014
Last updated
06/29/2016
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