NPIMap

Organization Active NPI

Life360 Community Services

  • Adolescent and Children Mental Health Clinic/Center
  • Springfield, MO
National Provider Identifier
1720751688
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
LIFE360 COMMUNITY SERVICES
Practice address
836 S Suburban Ave
Springfield, MO 65802-6774
Phone
(417) 658-5409
NPI assigned
Jul 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Mr. Gene Estrada Garcia I, MSNPI 1578916946
Title
Counseling Services Director
Phone
(417) 658-5409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

836 S Suburban Ave
Springfield, MO 65802-6774

Mailing address

2220 W Chesterfield Blvd
Springfield, MO 65807-8683
Phone (417) 447-9000

Other identifiers 1

IdentifierTypeStateIssuer
1578916946MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address counselingservices@life360.org Direct

National Provider Directory

National Provider Directory

Locations

2220 W Chesterfield Blvd
Springfield, MO 65807

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1720751688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 W CHESTERFIELD BLVD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078683",
            "telephone_number": "417-447-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 S SUBURBAN AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658026774",
            "telephone_number": "417-658-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE360 COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "ESTRADA",
        "authorized_official_title_or_position": "COUNSELING SERVICES DIRECTOR",
        "authorized_official_telephone_number": "417-658-5409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578916946",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "counselingservices@life360.org",
            "affiliation": "N",
            "endpointDescription": "counselingservices@life360.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "836 S Suburban Ave",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658026774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.