Provider Demographics
NPI:1619371127
Name:LIFE TOUCH LLC
Entity Type:Organization
Organization Name:LIFE TOUCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-315-5165
Mailing Address - Street 1:181 EAST EVANS ST.
Mailing Address - Street 2:SUITE 314
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506
Mailing Address - Country:US
Mailing Address - Phone:252-315-5165
Mailing Address - Fax:888-376-1118
Practice Address - Street 1:181 E EVANS ST
Practice Address - Street 2:SUITE 314
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2511
Practice Address - Country:US
Practice Address - Phone:252-315-5165
Practice Address - Fax:888-376-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health