| Lifeguide, Llc | |
|
1416 Ne 5th Ct Apt 4 Fort Lauderdale FL 33301-1272 | |
| (850) 345-8732 | |
| Not Available |
| Full Name | Lifeguide, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1416 Ne 5th Ct Apt 4, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Olushola A Lawal (CEO) |
| Authorized Official Contact | 8503458732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeguide, Llc 1416 Ne 5th Ct Apt 4 Fort Lauderdale FL 33301-1272 Ph: (850) 345-8732 | Lifeguide, Llc 1416 Ne 5th Ct Apt 4 Fort Lauderdale FL 33301-1272 Ph: (850) 345-8732 |
| NPI Number | 1073195483 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 04/26/2021 |
| Certification Date | 04/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073195483 | NPI | - | NPPES |
| 834950 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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