| Life Discovery Service Llc | |
|
10672 Us Highway 61 Jackson MO 63755-7171 | |
| (573) 837-7144 | |
| (636) 333-4510 |
| Full Name | Life Discovery Service Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10672 Us Highway 61, Jackson, Missouri |
| Authorized Official Name and Position | Melissa Hale (OWNER) |
| Authorized Official Contact | 5738377144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Discovery Service Llc Po Box 100 Pocahontas MO 63779-0100 Ph: (573) 837-7144 | Life Discovery Service Llc 10672 Us Highway 61 Jackson MO 63755-7171 Ph: (573) 837-7144 |
| NPI Number | 1770169765 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 12/21/2023 |
| Certification Date | 12/21/2023 |
| Medicare PECOS PAC ID | 7315354818 |
|---|---|
| Medicare Enrollment ID | O20210330000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770169765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melissa L Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063063956 PECOS PAC ID: 7618384116 Enrollment ID: I20210330001161 |
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