Life Design LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

8078982 Issued in ID

Legal business name

LIFE DESIGN LLC

Practice address

3420 Alturas CT
Pocatello, ID 83201-8024

Phone

(208) 242-3224

Fax

(208) 237-3685

NPI assigned

Jan 4, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Sandra Lee Roberts

Title

Professional Service Coordinator

Phone

(208) 242-3224

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203811200000",
    "number": "1871778183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 ALTURAS CT",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832018024",
            "telephone_number": "208-242-3224",
            "fax_number": "208-237-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 ALTURAS CT",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832018024",
            "telephone_number": "208-242-3224",
            "fax_number": "208-237-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE DESIGN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-02-24",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PROFESSIONAL SERVICE COORDINATOR",
        "authorized_official_telephone_number": "208-242-3224",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "ID",
            "license": "8078982",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "ID",
            "license": "8078941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8078982",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8078941",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Elizabeth Lewis
• Sophia Lex
• Ailun Li
• Henan Li
• Life Change Associates, PC
• Life, a Center for Independent Living (LIFE, Inc.)
• Lifepoint Rehab Physician Services LLC (Portneuf Rehabilitation Physician Services)
• Lighthouse for Recovery, LLC
• Dana F Liljenquist, D.C.
• Jacob Vaughn Liljenquist, DMD

• Case Management Agency in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Case Management Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2008; 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.