Life Well Lived Services, Inc.

Primary specialty

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

Legal business name

LIFE WELL LIVED SERVICES, INC.

Practice address

6941 Highway 92
Suite 120
Woodstock, GA 30189-3465

Phone

(770) 529-3754

Fax

(770) 693-8014

NPI assigned

Oct 24, 2013

Organization subpart

No

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

Authorized official

Name

Schnyeder Destine

Title

Executive Chairman

Phone

(770) 529-3754

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1689002958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6941 HIGHWAY 92",
            "address_2": "SUITE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893465",
            "telephone_number": "770-529-3754",
            "fax_number": "770-693-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6941 HIGHWAY 92",
            "address_2": "SUITE 120",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893465",
            "telephone_number": "770-529-3754",
            "fax_number": "770-693-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WELL LIVED SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "DESTINE",
        "authorized_official_first_name": "SCHNYEDER",
        "authorized_official_title_or_position": "EXECUTIVE CHAIRMAN",
        "authorized_official_telephone_number": "770-529-3754"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363207706B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elise Christine Lickteig
• Andries Matthys Liebenberg, LPC
• Lindsey Liebenberg, LMFT
• Cindy Mary Lieu, PHARMD
• Life Clinic of Ga PC
• Lilium Therapy Services LLC
• Jacqueline Alexandra Lilly, LPC
• Laura Anne Lim Sang
• Tracy Limes, LPC
• Limitless Disability Services

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.