Provider Demographics
NPI:1558990341
Name:BEST LIFE DAY CENTER
Entity Type:Organization
Organization Name:BEST LIFE DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELLANEY
Authorized Official - Middle Name:LASHAY JOHNSON
Authorized Official - Last Name:DIDDELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:912-322-2473
Mailing Address - Street 1:985 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-5907
Mailing Address - Country:US
Mailing Address - Phone:912-322-2473
Mailing Address - Fax:
Practice Address - Street 1:985 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-5907
Practice Address - Country:US
Practice Address - Phone:912-322-2473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No174200000XOther Service ProvidersMeals