| Lifeworks Substance Abuse Services Llc | |
|
4678 Tamiami Trl #105 Port Charlotte FL 33980-2900 | |
| (941) 979-5023 | |
| (941) 979-5064 |
| Full Name | Lifeworks Substance Abuse Services Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 4678 Tamiami Trl, Port Charlotte, Florida |
| Authorized Official Name and Position | Rhoadie Ladd (CEO) |
| Authorized Official Contact | 9419795023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeworks Substance Abuse Services Llc 4678 Tamiami Trl #105 Port Charlotte FL 33980-2900 Ph: (941) 979-5023 | Lifeworks Substance Abuse Services Llc 4678 Tamiami Trl #105 Port Charlotte FL 33980-2900 Ph: (941) 979-5023 |
| NPI Number | 1487055919 |
|---|---|
| Provider Enumeration Date | 09/16/2014 |
| Last Update Date | 06/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487055919 | NPI | - | NPPES |
| MH8565 | Other | FL | STATE OF FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH8565 (Florida) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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