Provider Demographics
NPI:1386897452
Name:EVERYDAY LIFE INC
Entity type:Organization
Organization Name:EVERYDAY LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:CEDRIC
Authorized Official - Middle Name:LASHUNN
Authorized Official - Last Name:PAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCCA,CART,CYC-P
Authorized Official - Phone:979-589-1885
Mailing Address - Street 1:6955 BROACH RD
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77808-8897
Mailing Address - Country:US
Mailing Address - Phone:979-589-1885
Mailing Address - Fax:979-589-1665
Practice Address - Street 1:6955 BROACH RD
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77808-8897
Practice Address - Country:US
Practice Address - Phone:979-589-1885
Practice Address - Fax:979-589-1665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX812341322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children