# LIFETIME SUPPORT INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447503636
- **Authorized official:** MRS. JAMIE DUNGEY (PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (973) 315-0027

## Contact information

- **Practice address:** 52 FADEM RD, SPRINGFIELD, NJ 07081-3116
- **Practice address phone:** (973) 315-0027
- **Mailing address:** 52 FADEM RD, SPRINGFIELD, NJ 07081-3116
- **Mailing address phone:** (973) 315-0027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2012
- **Last updated:** 10/25/2012