Organization
BREATHE NEW LYFE SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE L BRINKLEY (CEO)
(804) 467-1601
Entity
Organization
Contact information
Practice address
9856 LORI RD STE 100, CHESTERFIELD, VA 23832-6683
(804) 467-1601
Mailing address
9856 LORI RD STE 100, CHESTERFIELD, VA 23832-6683
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
04/29/2024
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