Organization
AMAZING LYF SUPPORT SERVICES LLC
Active
Other names
Amazing Lyf Support Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AARON WORLANYO ODUM (CEO)
(571) 409-9991
Entity
Organization
Contact information
Practice address
245 GARRISONVILLE RD STE 102, STAFFORD, VA 22554-8901
(571) 409-9991
(540) 779-5033
Mailing address
245 GARRISONVILLE RD STE 102, STAFFORD, VA 22554-8901
(571) 409-9991
(540) 779-5033
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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