Organization
LIFT FOR LIFE ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARSHALL COHEN (EXECUTIVE DIRECTOR)
(314) 436-2337
Entity
Organization
Contact information
Practice address
1731 S BROADWAY, SAINT LOUIS, MO 63104-4050
(314) 436-2337
(314) 231-1299
Mailing address
1731 S BROADWAY, SAINT LOUIS, MO 63104-4050
(314) 436-2337
(314) 231-1299
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
06/28/2007
Last updated
10/01/2007
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