Provider Demographics
NPI:1659181899
Name:THE LIFE GROUP
Entity type:Organization
Organization Name:THE LIFE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:C
Authorized Official - Last Name:BATTS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:301-651-9297
Mailing Address - Street 1:2509 HUNTLEY CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2983
Mailing Address - Country:US
Mailing Address - Phone:301-651-9297
Mailing Address - Fax:
Practice Address - Street 1:716 59TH AVE
Practice Address - Street 2:
Practice Address - City:FAIRMOUNT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-6504
Practice Address - Country:US
Practice Address - Phone:301-651-9297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health