Provider Demographics
NPI:1740572494
Name:LIFEHEALTH CENTER INC
Entity Type:Organization
Organization Name:LIFEHEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:H
Authorized Official - Last Name:UNGERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-345-0953
Mailing Address - Street 1:348 LUNENBURG ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-4566
Mailing Address - Country:US
Mailing Address - Phone:978-345-0953
Mailing Address - Fax:
Practice Address - Street 1:348 LUNENBURG ST
Practice Address - Street 2:SUITE 301
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-4566
Practice Address - Country:US
Practice Address - Phone:978-345-0953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty