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Organization
LYFE GLOBAL
Active
Organization
LYFE GLOBAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL C WILSON (EXECUTIVE DIRECTOR)
(609) 470-4283
Entity
Organization
Contact information
Practice address
44 E HAZELWOOD AVE, RAHWAY, NJ 07065-3813
(609) 470-4283
Mailing address
15 HAWTHORNE LN, WILLINGBORO, NJ 08046-1717
(609) 470-4283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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