Provider Demographics
NPI:1407179104
Name:TOTAL LIVING CENTER, INC.
Entity Type:Organization
Organization Name:TOTAL LIVING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-645-9547
Mailing Address - Street 1:6712 WASHINGTON AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-1999
Mailing Address - Country:US
Mailing Address - Phone:609-645-9547
Mailing Address - Fax:609-813-2318
Practice Address - Street 1:6712 WASHINGTON AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-1999
Practice Address - Country:US
Practice Address - Phone:609-645-9547
Practice Address - Fax:609-813-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management