Life Skills Village, PLLC
NPI 1629316815 · Community/Behavioral Health Agency · Oak Park, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1629316815
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Nate Gardin, Coo(248) 788-4300
Specialties & taxonomies
Agencies
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
- Rehabilitation Clinic/Center261QR0400X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4180 Pier North Blvd Ste BFlint, MI 48504-1361Phone: (248) 788-4300Fax: (248) 605-8099
Registry dates
- Enumerated
- 2013-01-22
- Last updated
- 2020-02-12
- Certified
- 2020-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.