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Organization
LIFE STYLES SUPPORTS, INC.
Active
Organization
LIFE STYLES SUPPORTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE ESTELLE HERNANDEZ (EXECUTIVE DIRECTOR)
(856) 589-5640
Entity
Organization
Contact information
Practice address
116 DENSTEN RD, SEWELL, NJ 08080-1890
(856) 589-5640
(856) 589-1516
Mailing address
PO BOX 594, SEWELL, NJ 08080-0594
(856) 589-5640
(856) 589-1516
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
347C00000X
Private Vehicle
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
NULL
Other
Enumeration date
06/02/2014
Last updated
06/16/2020
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