Provider Demographics
NPI:1437641909
Name:LIFE FOCUS CENTER, INC.
Entity type:Organization
Organization Name:LIFE FOCUS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-330-7990
Mailing Address - Street 1:2211 S HACIENDA BLVD STE 103C
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4642
Mailing Address - Country:US
Mailing Address - Phone:626-330-7990
Mailing Address - Fax:877-894-5104
Practice Address - Street 1:2211 S HACIENDA BLVD STE 103C
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4642
Practice Address - Country:US
Practice Address - Phone:626-330-7990
Practice Address - Fax:877-894-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALL90961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty