Provider Demographics
NPI:1477932150
Name:LIFE DESIGN SERVICES, INC.
Entity Type:Organization
Organization Name:LIFE DESIGN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:LAKEE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-217-9893
Mailing Address - Street 1:837 MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:COLERAIN
Mailing Address - State:NC
Mailing Address - Zip Code:27924-9199
Mailing Address - Country:US
Mailing Address - Phone:252-356-1608
Mailing Address - Fax:
Practice Address - Street 1:837 MEADOW RD
Practice Address - Street 2:
Practice Address - City:COLERAIN
Practice Address - State:NC
Practice Address - Zip Code:27924-9199
Practice Address - Country:US
Practice Address - Phone:252-217-9893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health