NPIMap

Organization Active NPI

Lifeskills, Inc.

  • Community/Behavioral Health Agency
  • Bowling Green, KY
National Provider Identifier
1326237785
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
800004 Issued in KY
Legal business name
LIFESKILLS, INC.
Doing business as
Lifeskills Adult
Practice address
380 Suwannee Trail St.
Bowling Green, KY 42103-7956
Phone
(270) 901-5000
Fax
(270) 842-5268
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joe Dan Beavers
Title
Ceo
Phone
(270) 901-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 800004 KY Primary

Addresses

Primary practice location

380 Suwannee Trail St.
Bowling Green, KY 42103-7956

Mailing address

380 Suwannee Trail St.
Bowling Green, KY 42103-7956
Phone (270) 901-5000

Other identifiers 1

IdentifierTypeStateIssuer
27004019MedicaidKY

Other names 1

  • Lifeskills Adult Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Allen County Service Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

380 Suwannee Trail St
Bowling Green, KY 42103

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1326237785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUWANNEE TRAIL ST.",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037956",
            "telephone_number": "270-901-5000",
            "fax_number": "270-842-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SUWANNEE TRAIL ST.",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037956",
            "telephone_number": "270-901-5000",
            "fax_number": "270-842-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESKILLS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "JOE DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-901-5000"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "800004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27004019",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeskills Adult",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifeskills Adult",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.