Organization
LIFETIME HEALTHCHOICE LLC
Active
Organization
LIFETIME HEALTHCHOICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS YEBOAH KORDIE DNP (OWNER/NURSE PRACTITIONER)
(973) 641-8836
Entity
Organization
Contact information
Practice address
134 EVERGREEN PL STE 705, EAST ORANGE, NJ 07018-2012
(973) 641-8836
(973) 695-3795
Mailing address
36 HAWTHORNE PL APT 4M, MONTCLAIR, NJ 07042-3277
(973) 641-8836
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
07/10/2018
Last updated
01/07/2025
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