Organization
L.I.F.E CENTER FOR INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM AZINGER (EXECUTIVE DIRECTOR)
(573) 756-4314
Entity
Organization
Contact information
Practice address
1109 STE. GENEVIEVE AVE, FARMINGTON, MO 63640
(573) 756-4314
(573) 756-3507
Mailing address
1109 STE. GENEVIEVE AVE, FARMINGTON, MO 63640
(573) 756-4314
(573) 756-3507
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/23/2006
Last updated
08/22/2020
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