# THE LIFE CENTER COMPLEX, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Life Health Center at Kuumba
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144198003
- **Authorized official:** MR. FORREST WATSON III (CEO)
- **Authorized official phone:** (302) 407-5316

## Contact information

- **Practice address:** 1200 N FRENCH ST, WILMINGTON, DE 19801-3239
- **Practice address phone:** (302) 407-5316
- **Mailing address:** 812 PHILADELPHIA PIKE STE F, WILMINGTON, DE 19809-2371
- **Mailing address phone:** (302) 407-5316
- **Mailing address fax:** (302) 407-5307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 10/23/2025
- **Last updated:** 10/23/2025