Provider Demographics
NPI:1861120917
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:LCSW
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:305-606-3313
Mailing Address - Fax:305-328-8345
Practice Address - Street 1:15300 SW 288TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1355
Practice Address - Country:US
Practice Address - Phone:305-224-6402
Practice Address - Fax:305-328-8345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center