Provider Demographics
NPI:1477293934
Name:BEST LIFE THERAPY
Entity Type:Organization
Organization Name:BEST LIFE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:301-722-0616
Mailing Address - Street 1:109 MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-1407
Mailing Address - Country:US
Mailing Address - Phone:301-722-0616
Mailing Address - Fax:301-722-2785
Practice Address - Street 1:323 PACA ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2816
Practice Address - Country:US
Practice Address - Phone:301-722-0616
Practice Address - Fax:301-722-2785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty