# LIFE INDIVIDUAL FAMILY ENRICHMENT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Life
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205016490
- **Authorized official:** JERRY LEWIS TAYLOR (DIRECTOR)
- **Authorized official phone:** (386) 523-8287

## Contact information

- **Practice address:** 153 WHITE FAWN DR, DAYTONA BEACH, FL 32114-1464
- **Practice address phone:** (386) 523-8287
- **Practice address fax:** (386) 523-8287
- **Mailing address:** 153 WHITE FAWN DR, DAYTONA BEACH, FL 32114-1464
- **Mailing address phone:** (386) 523-8287
- **Mailing address fax:** (386) 523-8287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 11/06/2007