Organization
A BEAUTIFUL LIFE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK SPARKS (VICE PRESIDENT)
(609) 839-8564
Entity
Organization
Contact information
Practice address
7321 SMITH AVE, MAYS LANDING, NJ 08330-4133
(908) 892-7317
Mailing address
7321 SMITH AVE, MAYS LANDING, NJ 08330-4133
(908) 892-7317
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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