Organization
LIFETIES, INC TRIAD SPECIAL NEEDS
Active
Parent organization
LIFETIES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIES, INC.
Authorized official
MISS MARY M INZANA (C.E.O./FOUNDER)
(609) 771-1600
Entity
Organization
Contact information
Practice address
2205 PENNINGTON RD, EWING, NJ 08638-1212
(609) 771-1600
(609) 530-1648
Mailing address
2205 PENNINGTON RD, EWING, NJ 08638-1212
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0297933
—
NJ
Enumeration date
09/27/2012
Last updated
09/27/2012
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