Organization
L.I.F.E. INC.
Active
Other names
L.I.F.E. Adult Medical Day Care
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA MARIE FORREST (CHIEF OPERATING OFFICER)
(410) 735-5433
Entity
Organization
Contact information
Practice address
4805 BENSON AVENUE, BALTIMORE, MD 21227
(410) 735-5433
(410) 735-5431
Mailing address
2822 HOLLINS FERRY ROAD, BALTIMORE, MD 21230
(410) 735-5433
(410) 735-5431
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
702205100
MD
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
DDA-17237-05
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7022055100
—
MD
Enumeration date
07/10/2007
Last updated
03/06/2019
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