| Life Way Services | |
|
7228 Statesman Blvd Ruther Glen VA 22546-5246 | |
| (804) 296-7875 | |
| Not Available |
| Full Name | Life Way Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7228 Statesman Blvd, Ruther Glen, Virginia |
| Authorized Official Name and Position | Ivana A Gray (OWNER/PARTNER) |
| Authorized Official Contact | 8042967875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Way Services 7228 Statesman Blvd Ruther Glen VA 22546-5246 Ph: (804) 296-7875 | Life Way Services 7228 Statesman Blvd Ruther Glen VA 22546-5246 Ph: (804) 296-7875 |
| NPI Number | 1982248704 |
|---|---|
| Provider Enumeration Date | 11/05/2019 |
| Last Update Date | 11/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982248704 | NPI | - | NPPES |
| 8042967875 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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