Provider Demographics
NPI:1215566393
Name:LIVE LIFE NOW HEALTH GROUP OF NJ PC
Entity Type:Organization
Organization Name:LIVE LIFE NOW HEALTH GROUP OF NJ PC
Other - Org Name:MONUMENT TELEHEALTH GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-971-8812
Mailing Address - Street 1:309 FELLOWSHIP RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:309 FELLOWSHIP RD STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1234
Practice Address - Country:US
Practice Address - Phone:646-960-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty