Life Development & Health Services

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIFE DEVELOPMENT & HEALTH SERVICES

Doing business as

LDHS

Practice address

12848 Queensbury LN Ste 208
Houston, TX 77024-4163

Phone

(866) 806-5347

Fax

(216) 710-6801

NPI assigned

Nov 11, 2021

Last updated

Nov 11, 2021By 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

Mr. Austin George Benamon

Title

Chief Executive Officer

Phone

(866) 806-5347

Specialties & licenses 15

Addresses

Other names 1

• LDHS Doing business as

Electronic endpoints 1

Tax ID family

Life Development Health Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Life Development & Health Services Corporation

  dba Cleveland/Beachwood

  • Multi-Specialty Clinic/Center
  • Beachwood, OH
  • NPI 1285381889
  NPD tax ID
• Life Development & Health Services Corporation

  dba Atlanta - Buckhead

  • Multi-Specialty Clinic/Center
  • Atlanta, GA
  • NPI 1801543459
  NPD tax ID

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1821754193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12848 QUEENSBURY LN STE 208",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770244163",
            "telephone_number": "866-806-5347",
            "fax_number": "216-710-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12848 QUEENSBURY LN STE 208",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770244163",
            "telephone_number": "866-806-5347",
            "fax_number": "216-710-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE DEVELOPMENT & HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "BENAMON",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "866-806-5347",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medicalrecords@lifedhs.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12848 Queensbury Ln Ste 208",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770244163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "LDHS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Life Bridge Medical Supply LLC
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• Life Changing Support LLC
• Life Cycles Counseling
• Life Development & Health Services Corporation (LDHS)
• Life Drugs RX LLC (Life Drugs Rx)
• Life Enhancement Services of Texas LLC
• Life Enhancement Services, LLC
• Life Guide Ambulance Services Inc (Life Guide Ambulance Services)

• Multi-Specialty Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.