Provider Demographics
NPI:1295133544
Name:BETTER LIFE SUPPORTIVE SERVICES, LLC
Entity type:Organization
Organization Name:BETTER LIFE SUPPORTIVE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL-WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS DEGREE, IMHC
Authorized Official - Phone:813-361-9579
Mailing Address - Street 1:34432 CLIFFCREEK CT
Mailing Address - Street 2:A-3
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4804
Mailing Address - Country:US
Mailing Address - Phone:813-361-9579
Mailing Address - Fax:813-395-8724
Practice Address - Street 1:10069 N FLORIDA AVE
Practice Address - Street 2:SUITE: A-3
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7447
Practice Address - Country:US
Practice Address - Phone:813-252-3971
Practice Address - Fax:813-252-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management