Life Way Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LIFE WAY SERVICES

Practice address

7228 Statesman Blvd
Ruther Glen, VA 22546-5246

Phone

(804) 296-7875

NPI assigned

Nov 5, 2019

Organization subpart

No

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

Authorized official

Name

Ivana A Gray

Title

Owner/Partner

Phone

(804) 296-7875

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": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1982248704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7228 STATESMAN BLVD",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225465246",
            "telephone_number": "804-296-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7228 STATESMAN BLVD",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "225465246",
            "telephone_number": "804-296-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WAY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "IVANA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "804-296-7875"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8042967875",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://mail.domain.com/EWS/Exchange.asmx",
            "affiliation": "N",
            "endpointDescription": "Outlook Exchange",
            "address_1": "7228 Statesman Blvd",
            "city": "Ruther Glen",
            "state": "VA",
            "country_code": "US",
            "postal_code": "225465246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Ruther Glen, VA
• Providers in Ruther Glen, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.