Organization
LIFE OPPORTUNITIES UNLIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL TAMIRIAN MANDELI (EXECUTIVE DIRECTOR)
(201) 689-1128
Entity
Organization
Contact information
Practice address
3 PINE ST, MIDLAND PARK, NJ 07432-1128
(201) 689-1128
Mailing address
75 N MAPLE AVE, SUITE 104, RIDGEWOOD, NJ 07450-3247
(201) 689-1128
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
GH735
NJ
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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