Life's Journey | |
2551 Eltham Ave Ste F Norfolk VA 23513-2505 | |
(757) 622-0700 | |
(757) 622-2400 |
Full Name | Life's Journey |
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Speciality | Clinic/Center |
Location | 2551 Eltham Ave Ste F, Norfolk, Virginia |
Authorized Official Name and Position | Shante Lenise Williams (COO) |
Authorized Official Contact | 7576220700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Life's Journey 2551 Eltham Ave Ste F Norfolk VA 23513-2505 Ph: (757) 622-0700 | Life's Journey 2551 Eltham Ave Ste F Norfolk VA 23513-2505 Ph: (757) 622-0700 |
NPI Number | 1639533672 |
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Provider Enumeration Date | 04/06/2016 |
Last Update Date | 11/24/2020 |
Certification Date | 11/24/2020 |
Medicare PECOS PAC ID | 8921410507 |
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Medicare Enrollment ID | O20201228000040 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639533672 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Louisa A Ayafor |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1013165695 PECOS PAC ID: 8123283728 Enrollment ID: I20181016000685 |
Provider Name | Nakkia N Grimes |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194168278 PECOS PAC ID: 2163834748 Enrollment ID: I20201228000183 |
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