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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
The Life Health Center @ Edgemont
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE LIFE CENTER COMPLEX, INC
Authorized official
MR. FORREST WATSON III (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 FL 2, WILMINGTON, DE 19809-2372
(302) 407-5316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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