Provider Demographics
NPI:1942048251
Name:LIFEWAY PROGRAMS INC
Entity type:Organization
Organization Name:LIFEWAY PROGRAMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAYELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-224-6402
Mailing Address - Street 1:30722 SW 149TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-4412
Mailing Address - Country:US
Mailing Address - Phone:888-331-3060
Mailing Address - Fax:305-328-8345
Practice Address - Street 1:10621 TUCKER JONES RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7637
Practice Address - Country:US
Practice Address - Phone:800-331-3060
Practice Address - Fax:305-328-8345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health