Life Impact Rehabilitation Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE IMPACT REHABILITATION SERVICES, LLC

Practice address

4920 Millridge Pkwy E Ste 220
Midlothian, VA 23112-4857

Phone

(804) 402-1189

NPI assigned

Feb 20, 2023

Last updated

Sep 30, 2026By 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

Leterrias Andrews

Title

Ceo

Phone

(804) 402-1189

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790726400000",
    "number": "1962100818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 MILLRIDGE PKWY E STE 220",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124857",
            "telephone_number": "804-402-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 MILLRIDGE PKWY E STE 220",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124857",
            "telephone_number": "804-402-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE IMPACT REHABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "LETERRIAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-402-1189"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lifeimpactservices.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "4920 Millridge Pkwy E Ste 220",
            "city": "Midlothian",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231124857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.