Healthcare Provider Details

I. General information

NPI: 1134821135
Provider Name (Legal Business Name): SAME LIFE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 OLD GREENBRIER RD STE 103-104
CHESAPEAKE VA
23320-2649
US

IV. Provider business mailing address

1604 TETON CT
CHESAPEAKE VA
23320-3888
US

V. Phone/Fax

Practice location:
  • Phone: 757-581-2063
  • Fax:
Mailing address:
  • Phone: 757-581-2063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: JAYLA DANICE HARRIS
Title or Position: CEO/DIRECTOR
Credential: MS, QDDP
Phone: 757-581-2063