LIFE SKILLS VILLAGE, PLLC – Community/Behavioral Health Agency, NPI 1629316815
Community/Behavioral Health Agency
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LIFE SKILLS VILLAGE, PLLC
4180 Pier North Blvd Ste B
Flint, MI 485041361
Phone: (248) 788-4300
Fax: (248) 605-8099
Type: Location
20010 FARMINGTON RD
LIVONIA, MI 481521408
Phone: (248) 788-4300
Fax: (248) 605-8099
Type: Mailing
25900 GREENFIELD RD
SUITE 100
OAK PARK, MI 482371292
Phone: (248) 788-4300
Fax: (248) 605-8099
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-04-21
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-08-31 (1019 days ago).
Enrollment records
1
Earliest due date
2023-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20140421000357 | O | Clinic/Group Practice | MI | 2023-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48504)
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