Provider Demographics
NPI:1649982471
Name:LIFE SKILLS NORTH
Entity type:Organization
Organization Name:LIFE SKILLS NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CAADC, CSAC
Authorized Official - Phone:906-285-2738
Mailing Address - Street 1:101 E MARY ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:MI
Mailing Address - Zip Code:49911-1457
Mailing Address - Country:US
Mailing Address - Phone:906-285-2738
Mailing Address - Fax:906-292-8063
Practice Address - Street 1:101 E MARY ST STE 6
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:MI
Practice Address - Zip Code:49911-1457
Practice Address - Country:US
Practice Address - Phone:906-285-2738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty