Organization
A GOOD LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WOLANZYK LCSW (OWNER, THERAPIST)
(256) 431-8190
Entity
Organization
Contact information
Practice address
117 CRESCENT DR, WILLIAMSBURG, VA 23188-1043
(256) 431-8190
Mailing address
117 CRESCENT DR, WILLIAMSBURG, VA 23188-1043
(256) 431-8190
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
04/06/2023
Last updated
04/18/2023
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