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
—
—
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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