| Lifebridge | |
|
188 High St Apt 2 Nutley NJ 07110-1181 | |
| (973) 336-0144 | |
| Not Available |
| Full Name | Lifebridge |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 188 High St Apt 2, Nutley, New Jersey |
| Authorized Official Name and Position | Dylan Bahaw (CEO) |
| Authorized Official Contact | 9733360144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifebridge 188 High St Apt 2 Nutley NJ 07110-1181 Ph: (973) 336-0144 | Lifebridge 188 High St Apt 2 Nutley NJ 07110-1181 Ph: (973) 336-0144 |
| NPI Number | 1407681497 |
|---|---|
| Provider Enumeration Date | 09/07/2024 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407681497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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