LIFETIME HEALTHCHOICE LLC


Address: 36 Hawthorne Pl Apt 4m, Montclair, NJ 07042-3277
Phone: 9736418836

LIFETIME HEALTHCHOICE LLC (NPI# 1073009338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073009338
Entity Type Organization
Organization Name LIFETIME HEALTHCHOICE LLC
Practice Address 36 Hawthorne Pl Apt 4m
Montclair
NJ 07042-3277
Practice Telephone 9736418836
Mailing Telephone 9736418836
Enumeration Date 2018-07-10
Last Update Date 2018-07-10
Authorized Official Name MR. DENNIS YEBOAH KORDIE (OWNER/NURSE PRACTITIONER)
Authorized Official Telephone 9736418836
Authorized Official Credential DNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD1600X Clinic/Center
Specialization: Developmental Disabilities
Ambulatory Health Care Facilities

Office Location

Street Address 36 HAWTHORNE PL APT 4M
City MONTCLAIR
State NJ
Zip Code 07042-3277

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Taxonomy Information

Taxonomy Code 261QD1600X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Developmental Disabilities

Taxonomy Definition

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Notes: [7/1/2003: new]

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Competitor

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City MONTCLAIR
Zip Code 07042

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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