Provider Demographics
| NPI: | 1417546417 |
|---|---|
| Name: | LIFE SKILLS ENHANCEMENT SERVICES, LLC |
| Entity type: | Organization |
| Organization Name: | LIFE SKILLS ENHANCEMENT SERVICES, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | PATRICIA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | LAWSON CHUKWUDI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 757-575-8699 |
| Mailing Address - Street 1: | 780 LYNNHAVEN PKWY STE 400 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | VIRGINIA BEACH |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 23452-7332 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 757-575-8699 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2085 LYNNHAVEN PKWY # 106-324 |
| Practice Address - Street 2: | |
| Practice Address - City: | VIRGINIA BEACH |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 23456-1497 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 757-373-1663 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-01-13 |
| Last Update Date: | 2024-08-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 253Z00000X | Agencies | In Home Supportive Care | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 251B00000X | Agencies | Case Management | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
| No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 385H00000X | Respite Care Facility | Respite Care | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
| No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 385HR2050X | Respite Care Facility | Respite Care | Respite Care Camp |
| No | 385HR2055X | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
| No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |