Its My Life LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ITS MY LIFE LLC

Practice address

3346 Bangor Cres
Chesapeake, VA 23321-4449

Phone

(757) 949-7186

NPI assigned

Aug 5, 2022

Last updated

Aug 5, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tiffani Gatson

Title

Ceo

Phone

(757) 949-7186

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1518694975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3346 BANGOR CRES",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233214449",
            "telephone_number": "757-949-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3346 BANGOR CRES",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233214449",
            "telephone_number": "757-949-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ITS MY LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "GATSON",
        "authorized_official_first_name": "TIFFANI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-949-7186",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DBHDS LICENSING NUMBER",
            "identifier": "4070",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TgatsonIML2020@icloud.com",
            "affiliation": "N",
            "address_1": "3346 Bangor Cres",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233214449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.