Provider Demographics
NPI:1295055341
Name:LIFES JOURNEY FAMILY SERVICES INC
Entity type:Organization
Organization Name:LIFES JOURNEY FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DAZA
Authorized Official - Last Name:LUCUMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-302-4248
Mailing Address - Street 1:2314 S MIAMI BLVD STE 154
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5796
Mailing Address - Country:US
Mailing Address - Phone:919-638-6419
Mailing Address - Fax:
Practice Address - Street 1:923 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4093
Practice Address - Country:US
Practice Address - Phone:919-638-6419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health