Provider Demographics
NPI:1407441322
Name:REFINED LIFE SOLUTIONS LLC
Entity Type:Organization
Organization Name:REFINED LIFE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ASHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-854-0113
Mailing Address - Street 1:3412 MEADOWDALE DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2236
Mailing Address - Country:US
Mailing Address - Phone:443-854-0113
Mailing Address - Fax:443-836-4006
Practice Address - Street 1:6302 N POINT RD STE F
Practice Address - Street 2:
Practice Address - City:SPARROWS POINT
Practice Address - State:MD
Practice Address - Zip Code:21219-1000
Practice Address - Country:US
Practice Address - Phone:144-385-4011
Practice Address - Fax:443-836-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health