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Organization
THE LIFE CENTER COMPLEX, INC
Active
Organization
THE LIFE CENTER COMPLEX, INC
Active
Parent organization
THE LIFE CENTER COMPLEX, INC
Other names
Life Health Center @ Toby Farms
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE LIFE CENTER COMPLEX, INC
Authorized official
FORREST WATSON (CEO)
(302) 407-5316
Entity
Organization
Contact information
Practice address
1350 EDGMONT AVE, CHESTER, PA 19013-3962
(302) 407-5316
Mailing address
812 PHILADELPHIA PIKE STE F, WILMINGTON, DE 19809-2371
(302) 407-5316
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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