Provider Demographics
NPI:1134515216
Name:MORE 2 LYFE, INC
Entity Type:Organization
Organization Name:MORE 2 LYFE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-222-3924
Mailing Address - Street 1:1408 ALMONDBERRY PL
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-4793
Mailing Address - Country:US
Mailing Address - Phone:804-222-3924
Mailing Address - Fax:804-222-3924
Practice Address - Street 1:1408 ALMONDBERRY PL
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-4793
Practice Address - Country:US
Practice Address - Phone:804-222-3924
Practice Address - Fax:804-222-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty