Provider Demographics
NPI:1134460538
Name:LIFE COMPREHENSIVE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:LIFE COMPREHENSIVE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-530-4700
Mailing Address - Street 1:3331 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4554
Mailing Address - Country:US
Mailing Address - Phone:732-530-4700
Mailing Address - Fax:732-455-8855
Practice Address - Street 1:3331 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4554
Practice Address - Country:US
Practice Address - Phone:732-530-4700
Practice Address - Fax:732-455-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-09
Last Update Date:2013-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3245261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty