Organization
LIFE TRIBE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PHELPS BCBA (PRESIDENT/CEO)
(727) 201-2389
Entity
Organization
Contact information
Practice address
1 W COURT SQ STE 750, DECATUR, GA 30030-2545
(727) 201-2389
Mailing address
5940 SEABIRD DR S, GULFPORT, FL 33707-3936
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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