Organization
THROUGH THE LIFETIME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON TEAGUE (OWNER)
(905) 956-3875
Entity
Organization
Contact information
Practice address
133 DENNIS ST, ROSELLE, NJ 07203-2547
(908) 956-3875
Mailing address
133 DENNIS ST, ROSELLE, NJ 07203-2547
(908) 956-3875
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44SC01288200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0548511
—
NJ
Enumeration date
04/17/2017
Last updated
04/17/2017
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