Provider Demographics
NPI:1649813478
Name:ALTRUISTIC LIFE SERVICES, INC.
Entity type:Organization
Organization Name:ALTRUISTIC LIFE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-608-9759
Mailing Address - Street 1:4222 BONNIEBANK RD STE 203
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6632
Mailing Address - Country:US
Mailing Address - Phone:804-608-9759
Mailing Address - Fax:833-252-0862
Practice Address - Street 1:2443 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-4811
Practice Address - Country:US
Practice Address - Phone:804-608-9759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities