Organization
LIFE OF PURPOSE - PENNSYLVANIA
Active
Parent organization
LIFE OF PURPOSE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE OF PURPOSE, LLC
Authorized official
BRANDEN COLUCCIO (CFO)
(877) 636-9322
Entity
Organization
Contact information
Practice address
225 E CITY AVE STE 15, BALA CYNWYD, PA 19004-1724
(877) 636-9322
(866) 417-4309
Mailing address
PO BOX 826742, PHILADELPHIA, PA 19182-6742
(877) 636-9322
(866) 417-4309
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
467132
PA
Other
Enumeration date
07/13/2016
Last updated
01/25/2019
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