Provider Demographics
NPI:1538504543
Name:LIFE SOLUTIONS OUTPATIENT
Entity Type:Organization
Organization Name:LIFE SOLUTIONS OUTPATIENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-678-0078
Mailing Address - Street 1:901 NORTHPOINT PKWY STE 304
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1953
Mailing Address - Country:US
Mailing Address - Phone:954-678-0078
Mailing Address - Fax:954-370-6447
Practice Address - Street 1:901 NORTHPOINT PKWY STE 304
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1953
Practice Address - Country:US
Practice Address - Phone:954-678-0078
Practice Address - Fax:954-370-6447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No291U00000XLaboratoriesClinical Medical Laboratory