Organization
LIFESPAN BEHAVIORAL SERVICES PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYRON WINE PHD, BCBA, LBA (OWNER)
(321) 427-2438
Entity
Organization
Contact information
Practice address
2333 SCHENLEY DR, NORTH CHESTERFIELD, VA 23235-3317
(321) 427-2438
Mailing address
2333 SCHENLEY DR, NORTH CHESTERFIELD, VA 23235-3317
(321) 427-2438
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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