| Life360 Community Services | |
|
836 S Suburban Ave Springfield MO 65802-6774 | |
| (417) 658-5409 | |
| Not Available |
| Full Name | Life360 Community Services |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 836 S Suburban Ave, Springfield, Missouri |
| Authorized Official Name and Position | Gene Estrada Garcia (COUNSELING SERVICES DIRECTOR) |
| Authorized Official Contact | 4176585409 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life360 Community Services 2220 W Chesterfield Blvd Springfield MO 65807-8683 Ph: (417) 447-9000 | Life360 Community Services 836 S Suburban Ave Springfield MO 65802-6774 Ph: (417) 658-5409 |
| NPI Number | 1720751688 |
|---|---|
| Provider Enumeration Date | 07/27/2021 |
| Last Update Date | 03/01/2022 |
| Certification Date | 03/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720751688 | NPI | - | NPPES |
| 1578916946 | Medicaid | MO |
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