Organization
LIFE CHOICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN FASANELLO (DIRECTOR)
(908) 213-6974
Entity
Organization
Contact information
Practice address
156 S MAIN ST, PHILLIPSBURG, NJ 08865-2827
(908) 387-0020
(908) 213-6974
Mailing address
411 S MAIN ST, PHILLIPSBURG, NJ 08865-3018
(908) 213-6974
(908) 213-6974
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MB064321
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083291
—
NJ
Enumeration date
05/15/2007
Last updated
08/22/2020
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