Provider Demographics
NPI:1902031503
Name:LIFE LESSONS RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:LIFE LESSONS RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETTA
Authorized Official - Middle Name:PORTER
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-562-7461
Mailing Address - Street 1:7023 MADRAS CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-8399
Mailing Address - Country:US
Mailing Address - Phone:804-562-7461
Mailing Address - Fax:804-562-7462
Practice Address - Street 1:7023 MADRAS CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8399
Practice Address - Country:US
Practice Address - Phone:804-562-7461
Practice Address - Fax:804-562-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1183786320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness