Provider Demographics
NPI:1104221555
Name:LIFE FORCE SENIOR CARE CORPORATION
Entity Type:Organization
Organization Name:LIFE FORCE SENIOR CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-667-2922
Mailing Address - Street 1:1060 KINGS HWY N STE 314
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1910
Mailing Address - Country:US
Mailing Address - Phone:856-667-2922
Mailing Address - Fax:856-330-8952
Practice Address - Street 1:1060 KINGS HWY N STE 314
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1910
Practice Address - Country:US
Practice Address - Phone:856-667-2922
Practice Address - Fax:856-330-8952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0177100253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care