Provider Demographics
NPI:1437620358
Name:LIFEWAYS, INC
Entity Type:Organization
Organization Name:LIFEWAYS, INC
Other - Org Name:LIFEWAYS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEKSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-889-9167
Mailing Address - Street 1:702 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-3121
Mailing Address - Country:US
Mailing Address - Phone:541-889-9167
Mailing Address - Fax:541-889-9167
Practice Address - Street 1:8050 W NORTHVIEW ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7126
Practice Address - Country:US
Practice Address - Phone:208-327-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFEWAYS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-17
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)