Provider Demographics
NPI:1700922036
Name:LIFE WAY SYSTEMS, INC
Entity Type:Organization
Organization Name:LIFE WAY SYSTEMS, INC
Other - Org Name:LIFE WAY SENIOR CARE AND COMPANION SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:256-351-1090
Mailing Address - Street 1:3621 US HWY 31 S #A
Mailing Address - Street 2:POST OFFICE BOX 1309
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-1309
Mailing Address - Country:US
Mailing Address - Phone:256-351-1090
Mailing Address - Fax:256-308-0803
Practice Address - Street 1:3621 US HIGHWAY 31 S # A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1633
Practice Address - Country:US
Practice Address - Phone:256-351-1090
Practice Address - Fax:256-308-0803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL07683372600000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty