Provider Demographics
NPI:1467989012
Name:LIFE TOUCH SERVICES, LLC
Entity Type:Organization
Organization Name:LIFE TOUCH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:804-271-6725
Mailing Address - Street 1:9321 MIDLOTHIAN TPKE STE J
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4941
Mailing Address - Country:US
Mailing Address - Phone:804-271-6527
Mailing Address - Fax:804-271-6729
Practice Address - Street 1:9321 MIDLOTHIAN TPKE STE J
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4941
Practice Address - Country:US
Practice Address - Phone:804-271-6527
Practice Address - Fax:804-271-6729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1080-03-001251S00000X
VA1080-01-001320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health