| Life Tribe Llc | |
|
2529 Central Ave St Petersburg FL 33713-8721 | |
| (727) 201-2389 | |
| (855) 224-4326 |
| Full Name | Life Tribe Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2529 Central Ave, St Petersburg, Florida |
| Authorized Official Name and Position | Jennifer Phelps (PRESIDENT/CEO) |
| Authorized Official Contact | 7272012389 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Tribe Llc 5940 Seabird Dr S Gulfport FL 33707-3936 Ph: (727) 201-2389 | Life Tribe Llc 2529 Central Ave St Petersburg FL 33713-8721 Ph: (727) 201-2389 |
| NPI Number | 1811532310 |
|---|---|
| Provider Enumeration Date | 11/08/2019 |
| Last Update Date | 11/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811532310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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