Organization
GUIDED LIFE STRUCTURES
Active
Organization
GUIDED LIFE STRUCTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN WEBER (EXECUTOR DIRECTOR)
(908) 704-0011
Entity
Organization
Contact information
Practice address
75 VETERANS MEMORIAL DR E STE 205, SOMERVILLE, NJ 08876-2949
(908) 704-0011
(908) 704-0011
Mailing address
75 VETERANS MEMORIAL DR E STE 205, SOMERVILLE, NJ 08876-2949
(908) 704-0011
(908) 704-0711
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
2000133
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0116378
NPI
NJ
Enumeration date
09/28/2017
Last updated
10/15/2017
Update your record
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