Provider Demographics
NPI:1326221797
Name:HOPE FOR LIFE, INC.
Entity Type:Organization
Organization Name:HOPE FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, CLT-LANA, CLM
Authorized Official - Phone:732-300-0886
Mailing Address - Street 1:116 CROW HILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4256
Mailing Address - Country:US
Mailing Address - Phone:732-300-0886
Mailing Address - Fax:
Practice Address - Street 1:116 CROW HILL RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-4256
Practice Address - Country:US
Practice Address - Phone:732-300-0886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA009484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty