| Leumas Lighted Life, Llc | |
|
32 W Clay St Salem VA 24153-3754 | |
| (540) 354-5565 | |
| (540) 387-0058 |
| Full Name | Leumas Lighted Life, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 32 W Clay St, Salem, Virginia |
| Authorized Official Name and Position | Shirley Hairston Everett (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5403545565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leumas Lighted Life, Llc 32 W Clay St Salem VA 24153-3754 Ph: (540) 354-5565 | Leumas Lighted Life, Llc 32 W Clay St Salem VA 24153-3754 Ph: (540) 354-5565 |
| NPI Number | 1265820880 |
|---|---|
| Provider Enumeration Date | 01/05/2015 |
| Last Update Date | 01/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265820880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2019-01-001 (Virginia) | Primary |
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