Provider Demographics
NPI:1144034026
Name:LYFE COMPREHENSIVE SERVICES LLC
Entity type:Organization
Organization Name:LYFE COMPREHENSIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:BREWSTER
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:804-938-4766
Mailing Address - Street 1:2223 EARLY SETTLERS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3832
Mailing Address - Country:US
Mailing Address - Phone:804-938-4766
Mailing Address - Fax:
Practice Address - Street 1:2223 EARLY SETTLERS RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3832
Practice Address - Country:US
Practice Address - Phone:804-938-4766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health