LIFE DEVELOPMENT RESOURCES, PA – Community/Behavioral Health Agency, NPI 1902953169

LIFE DEVELOPMENT RESOURCES, PA is a healthcare provider. based in Lakeville, Minnesota. specializing in Community/Behavioral Health Agency. The NPI Number for LIFE DEVELOPMENT RESOURCES, PA is 1902953169

Main info

Organization
Name
LIFE DEVELOPMENT RESOURCES, PA
NPI
1902953169
Phone
(952) 898-1133
Address
7580 160TH ST W
Authorized Official
KIM TRACY ROSS PROGRAM MANAGER
Enumeration Date
3 January 2007
Last Update Date
18 January 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:19State licenses:0Digital endpointsOther names

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Provider Addresses for LIFE DEVELOPMENT RESOURCES, PA

  • 7580, 160th Street West, Highview Heigh, Lakeville, Dakota County, Minnesota, 55044, United States

    LAKEVILLE, MN 550448348

    Phone: (952) 898-1133

    Mailing address matches the actual address.

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: 2004-06-16

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-08-31 (1020 days ago).

Enrollment records

1

Earliest due date

2023-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040616000985OClinic/Group PracticeMN2023-08-31

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.

Verify on CMS Revalidation Lookup Tool

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 55044)

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Reviews

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Frequently asked questions

Is there an official ID for LIFE DEVELOPMENT RESOURCES, PA in U.S. healthcare records?
The official identifier for LIFE DEVELOPMENT RESOURCES, PA is NPI 1902953169.
Is there an active status for LIFE DEVELOPMENT RESOURCES, PA?
For scheduling context, LIFE DEVELOPMENT RESOURCES, PA is shown as active in the registry.
What clinical focus is listed for LIFE DEVELOPMENT RESOURCES, PA?
At a glance, LIFE DEVELOPMENT RESOURCES, PA is tied to Community/Behavioral Health Agency. Clinical services aligned with this taxonomy classification.
Is LIFE DEVELOPMENT RESOURCES, PA associated with Lakeville?
Public fields place LIFE DEVELOPMENT RESOURCES, PA around Lakeville, Minnesota. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for LIFE DEVELOPMENT RESOURCES, PA is noted as January 3, 2007 where the registry provides it.

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