# THE LIFE CENTER COMPLEX, INC

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

## Provider details

- **NPI number:** 1770808578
- **Authorized official:** MR. FORREST WATSON III MBA (PRESIDENT)
- **Authorized official phone:** (302) 552-3574

## Contact information

- **Practice address:** 1624 JESSUP ST, WILMINGTON, DE 19802-4210
- **Practice address phone:** (302) 552-3574
- **Practice address fax:** (302) 552-3561
- **Mailing address:** 812 PHILADELPHIA PIKE STE F, WILMINGTON, DE 19809-2371
- **Mailing address phone:** (302) 407-5316
- **Mailing address fax:** (302) 552-3561

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TP2701X | Group Psychotherapy Psychologist | 71788 | DE | — |
| 261QC1500X | Community Health Clinic/Center | — | DE | Yes |

## Other

- **Enumeration date:** 04/05/2010
- **Last updated:** 03/28/2024