Life Way Services
Clinic/Center, Mental Health (Including Community Mental Health Center) in Ruther Glen, VA. Organization (NPI-2).
NPI number1982248704
StatusActive
Last updated in NPPESNov 5, 2019
Details
- NPI
- 1982248704
- Entity type
- Organization (NPI-2)
- Legal business name
- Life Way Services
- Organization subpart
- No
- Enumeration date
- Nov 5, 2019
- Last updated
- Nov 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
7228 Statesman BlvdRuther Glen, VA 22546-5246
Phone 804-296-7875
Mailing address
7228 Statesman BlvdRuther Glen, VA 22546-5246
Phone 804-296-7875
Authorized official
Ivana A Gray
Owner/Partner
8042967875
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