Organization
LIFE OPPORTUNITIES UNLIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL ANN TAMIRIAN-MANDELI M.ED (EXECUTIVE DIRECTOR)
(201) 689-1128
Entity
Organization
Contact information
Practice address
28 CLEVELAND AVE, WALDWICK, NJ 07463
(201) 689-1128
(201) 689-1136
Mailing address
75 NORTH MAPLE AVE, SUITE 104, RIDGEWOOD, NJ 07450
(201) 689-1128
(201) 689-1136
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0531545
—
NJ
Enumeration date
03/06/2019
Last updated
03/06/2019
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