MEDICARE: SAME LIFE SERVICES LLC

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1134821135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAME LIFE SERVICES LLC

Provider Business Mailing Address
First Line	:	1604 TETON CT
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-3888
Country	:	US
Telephone Number	:	757-581-2063
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 OLD GREENBRIER RD STE 103-104
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-2649
Country	:	US
Telephone Number	:	757-581-2063
Fax Number	:

Authorized Official
Title or Position	:	CEO/DIRECTOR
Name	:	JAYLA DANICE HARRIS
Credential	:	MS, QDDP
Telephone Number	:	757-581-2063

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/23/2026

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