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Contact Information

LIFE TREK, LLC
21 SYCAMORE ST
CABOT, AR72023-3714
 Phone: 501-617-5678
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIFE TREK, LLC

NPI Number 1861925968
LBN Legal business name LIFE TREK, LLC
Authorized official CATHY STATON - (PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/05/2017
Last updated 04/05/2017 - About 9 years ago
Identifiers
AR License # 17-04P
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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