Lifelong Good Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

D1100000386 Issued in DC

Legal business name

LIFELONG GOOD HEALTH LLC

Practice address

5721 Rhode Isalnd Drive
Woodbridge, VA 22193

Phone

(703) 389-6612

NPI assigned

Feb 19, 2015

Last updated

Feb 19, 2015By 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. Lucia Isac Mitchell, RDN

Title

Registered Dietitian Nutritionist

Phone

(703) 389-6612

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1588056139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14904 JEFFERSON DAVIS HWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913908",
            "telephone_number": "703-389-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 RHODE ISALND DRIVE",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "703-389-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG GOOD HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-19",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_middle_name": "ISAC",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN NUTRITIONIST",
        "authorized_official_telephone_number": "703-389-6612",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "DC",
            "license": "D1100000386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Waqas Liaqat
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• Lifeline Home Health Inc
• Lifelong Good Health
• Lifetime Dental Care
• Lifetime Therapy, LLC
• Lifeworks Outreach Services, Inc.
• Lifting As We Climb Community Services LLC.
• Lifting As We Climb Community Services, LLC

• Clinic/Center in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.