Provider Demographics
NPI:1477213783
Name:LIFE AFTER INCARCERATION INITIATIVE LLC
Entity Type:Organization
Organization Name:LIFE AFTER INCARCERATION INITIATIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:772-353-1697
Mailing Address - Street 1:300 E RICH ST APT 211
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5223
Mailing Address - Country:US
Mailing Address - Phone:614-772-3531
Mailing Address - Fax:
Practice Address - Street 1:300 E RICH ST APT 211
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5223
Practice Address - Country:US
Practice Address - Phone:772-353-1697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency