Organization
LIFETIES,INC./RAINBOW HOUSE
Active
Parent organization
LIFETIES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIES, INC.
Authorized official
MARY M INZANA (C.E.O./FOUNDER)
(609) 771-1600
Entity
Organization
Contact information
Practice address
1301 W STATE ST, TRENTON, NJ 08618-5227
(609) 394-6747
Mailing address
2205 PENNINGTON RD, EWING, NJ 08638-1212
(609) 771-1600
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0184691
—
NJ
Enumeration date
06/18/2009
Last updated
06/18/2009
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