MEDICARE: BETTER LIFE OF VIRGINIA 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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1154842292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER LIFE OF VIRGINIA LLC

Provider Business Mailing Address
First Line	:	1837 GRAVENHURST DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-8654
Country	:	US
Telephone Number	:	757-467-6662
Fax Number	:

Provider Business Practice Location Address
First Line	:	1837 GRAVENHURST DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-8654
Country	:	US
Telephone Number	:	757-467-6662
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BABATUNDE TONY TALABI
Credential	:
Telephone Number	:	757-467-6662

Provider Enumeration Date	:	06/29/2017
Last Update Date	:	07/21/2022

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