Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Rehabilitation, Substance Use Disorder |
261QR0405X |
| NPI # | 1760101794 |
| LBN Legal business name | LIFETORCH RECOVERY CENTER & WELLNESS LLC |
| Authorized official | EMILY LAGAT - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/23/2022 |
| Last updated | 11/26/2022 - About 4 years ago |
| Identifiers | n/a |
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