Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Community Health |
261QC1500X | |||
Community/Behavioral Health |
251S00000X | |||
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI Number | 1578125969 |
| LBN Legal business name | LIFES ENERGY WELLNESS CENTER INC. |
| Authorized official | ANDREA KELLEY-FREEMAN - (CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/05/2019 |
| Last updated | 07/05/2019 - About 7 years ago |
| Identifiers | n/a |
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