Healthcare Provider Details

I. General information

NPI: 1558293753
Provider Name (Legal Business Name): LIFE BALANCE FAMILY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8204 HEATHER RIDGE CT
HENRICO VA
23231-8949
US

IV. Provider business mailing address

8204 HEATHER RIDGE CT
HENRICO VA
23231-8949
US

V. Phone/Fax

Practice location:
  • Phone: 804-720-4071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: DASHAUN DEANDRE JONES-GRIFFIN
Title or Position: MANAGING MEMBER
Credential:
Phone: 804-516-5744