Organization
IMAGINE LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRYSTAL LEE ODELL M.ED. (OWNER)
(609) 529-6510
Entity
Organization
Contact information
Practice address
138 WALNFORD RD, ALLENTOWN, NJ 08501-1905
(609) 529-6510
Mailing address
138 WALNFORD RD, ALLENTOWN, NJ 08501-1905
(609) 529-6510
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
Other
Enumeration date
06/02/2013
Last updated
06/02/2013
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