Provider Demographics
NPI:1073243465
Name:LIFE SERVICES INC.
Entity Type:Organization
Organization Name:LIFE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-716-9723
Mailing Address - Street 1:7400 BEAUFONT SPRINGS DR STE 400
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5519
Mailing Address - Country:US
Mailing Address - Phone:804-716-9723
Mailing Address - Fax:
Practice Address - Street 1:7400 BEAUFONT SPRINGS DR STE 400
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-5519
Practice Address - Country:US
Practice Address - Phone:804-716-9723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health