Organization
LIFE GATE CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYORINDE OLADUNNI (OWNER)
(443) 870-0272
Entity
Organization
Contact information
Practice address
23 FOXMOOR CT, OWINGS MILLS, MD 21117-1291
(443) 870-0272
Mailing address
23 FOXMOOR CT, OWINGS MILLS, MD 21117-1291
(443) 870-0272
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450218989
BUSINESS REGISTRATION
NJ
Enumeration date
11/24/2017
Last updated
11/24/2017
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