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General NPI Number Information
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NPI Number | 1659181899
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Entity Type | Organization
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Legal Business Name | THE LIFE GROUP
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 716 59TH AVE
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City | FAIRMOUNT HEIGHTS
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State | MD
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Zip | 20743-6504
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Country | US
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Telephone | 301-651-9297
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 HUNTLEY CT
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City | BOWIE
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State | MD
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Zip | 20721-2983
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Country | US
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Telephone | 301-651-9297
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Fax |
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Authorized Official
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Title or Position | CEO/ FOUNDER
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Name | MR. DEXTER C. BATTS SR.
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Credential |
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Telephone | 301-651-9297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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