Provider Demographics
NPI:1265077911
Name:UNITED ASSISTANCE 4 LIFE, LLC
Entity type:Organization
Organization Name:UNITED ASSISTANCE 4 LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAUNDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-664-7311
Mailing Address - Street 1:4232 ARBOR MILL CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-3204
Mailing Address - Country:US
Mailing Address - Phone:706-664-7311
Mailing Address - Fax:
Practice Address - Street 1:4232 ARBOR MILL CIR
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-3204
Practice Address - Country:US
Practice Address - Phone:706-664-7311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-16
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services