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Organization
LIFE INDIVIDUAL FAMILY ENRICHMENT SERVICES
Active
Organization
LIFE INDIVIDUAL FAMILY ENRICHMENT SERVICES
Active
Other names
Life
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY LEWIS TAYLOR (DIRECTOR)
(386) 523-8287
Entity
Organization
Contact information
Practice address
153 WHITE FAWN DR, DAYTONA BEACH, FL 32114-1464
(386) 523-8287
(386) 523-8287
Mailing address
153 WHITE FAWN DR, DAYTONA BEACH, FL 32114-1464
(386) 523-8287
(386) 523-8287
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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