Provider Demographics
NPI:1427398858
Name:LIFE OPPORTUNITIES UNLIMITED A NON PROFIT CORP.
Entity Type:Organization
Organization Name:LIFE OPPORTUNITIES UNLIMITED A NON PROFIT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAMIRIAN-MANDELI
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:201-689-1128
Mailing Address - Street 1:75 N MAPLE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-689-1128
Mailing Address - Fax:201-689-1136
Practice Address - Street 1:75 NORTH MAPLE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-689-1128
Practice Address - Fax:201-689-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services