MEDICARE: WAY OF LIFE COMMUNITY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1265142590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAY OF LIFE COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	245 SERENITY RIDGE CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5913
Country	:	US
Telephone Number	:	702-406-9879
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 SERENITY RIDGE CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5913
Country	:	US
Telephone Number	:	702-406-9879
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. ANGELIQUE CHALALA
Credential	:	MS
Telephone Number	:	702-406-9879

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	11/28/2022

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Directions to “WAY OF LIFE COMMUNITY SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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