Provider Demographics
NPI:1467896472
Name:UNIVERSAL LIFE SERVICES LLC
Entity Type:Organization
Organization Name:UNIVERSAL LIFE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:CALVIN
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:BA,CSAC
Authorized Official - Phone:804-281-8959
Mailing Address - Street 1:4609 W BROAD ST
Mailing Address - Street 2:SUITE A2
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3205
Mailing Address - Country:US
Mailing Address - Phone:804-218-8959
Mailing Address - Fax:804-355-5420
Practice Address - Street 1:4609 W BROAD ST
Practice Address - Street 2:SUITE A2
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3205
Practice Address - Country:US
Practice Address - Phone:804-218-8959
Practice Address - Fax:804-355-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty