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General NPI Number Information
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NPI Number | 1467096750
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Entity Type | Organization
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Legal Business Name | LIFEWAY PROGRAMS INC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 15300 SW 288TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-1355
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Country | US
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Telephone | 305-224-6402
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Fax | 305-328-8345
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Provider Business Mailing Address
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Address Line | 30722 SW 149TH PL
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City | HOMESTEAD
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State | FL
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Zip | 33033-4412
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Country | US
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Telephone | 305-224-6402
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Fax | 305-328-8345
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MAYELIN LIMA
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Credential |
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Telephone | 305-606-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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