Organization
LIVE 4 LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JACKSON (CEO)
(757) 816-7842
Entity
Organization
Contact information
Practice address
2911 TURNER RD, ST B6, NORTH CHESTERFIELD, VA 23224-2545
(804) 447-7235
Mailing address
2911 TURNER RD, ST B6, NORTH CHESTERFIELD, VA 23224-2545
(804) 447-7235
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2012
Last updated
03/06/2017
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